INFLUENCE FACTORS ON CECAL INTUBATION RATE AS A QUALITY AND PERFORMANCE MEASUREMENT IN COLONOSCOPY

Aims:

Colonoscopy is a common performed procedure in Gastroenterology, and it's widely used for diagnosis, treatment and surveillance of a wide range of conditions and symptoms. Properly performed, it's generally safe, more accurate than a virtual colonoscopy and well-tolerated by pacients. The completion of a colonoscopy is defined by cecal intubation with the visualization of colonic mucosa and distal terminal ileum when it's possible.

Methods:

We reviewed retrospectively all consecutives endoscopies database of the lower digestive tract, done over a period from 2014 – 2017 in our clinic. The recommended completion based on the latest guidelines range from 90 – 95% completion rate according to the indication.

Results:

11214 consecutive colonoscopies were done. Over-all cecal intubation was successful in 9456 procedures.(87.3%). If we exclude the interventional procedures (414 procedures), where cecal intubation was not necessary, the main reasons of non-intubation were due to intolerance of the patients (388 pacients), followed on the second place by patients with obstructive cancer (299 pacients). The presence of diverticulosis, poor preparation for colonoscopy and post- surgical adhesions were significant findings in non-successful procedures.

Conclusions:

In normal daily practice, colonoscopy is completed in 88.01% of the procedures but we think that this result will stimulate the efforts to incorporate more quality measures and time in our endoscopy laboratory, by applying Quality Improvement Measures.