Key Performance Measures For Lower Gastrointestinal Endoscopy In A Tertiary Center

Aims Key performance measures for lower gastrointestinal endoscopy have been recommended by ESGE and other endoscopic societies, as a means of improving the quality of the services provided. The aim of this study is to assess the degree of implementation of performance measures into the daily endoscopic practice of our center during the past decade.

Methods We retrospectively analyzed the data from colonoscopies performed from 1/1/2010 until 31/12/2019 at our endoscopy center which is based in an academic hospital.

Results During the study period a total of 22.363 colonoscopies have been performed (mainly outpatients). 57.7 % of the study population were male. 3779 (16,9 %) were surveillance (adenoma/post polypectomy, post CRC/colectomy) colonoscopies, 6731 (30.1 %) screening, 5122 (22.9 %) non alarm symptoms, 3980 (17.8 %) alarm symptoms, 1118 (5 %) IBD, 1632 (7.3 %) scheduled polypectomies.

Cecal intubation was successful in 20.730 (92.7 %). Failure to reach the cecum was associated with the indication. Failure to complete the examination was significantly higher in symptomatic patients (13,3 %), compared to only 4,7 % of screening patients (p=0.00016) and 5 % of follow-up patients (p=0.00539). The quality of bowel preparation was rated as good/excellent in only 18.665 colonoscopies (83.5 %).

The complication rate was 0.49 %: Eleven perforations following colonoscopy have been reported (0.04 %), 85 post-polypectomy bleedings (0,3 %) and 6 patients with post polypectomy syndrome (0.02 %).

Overall polyp detection rate (PDR) at first colonoscopy was 41 % for screening patients and 33 % for symptomatic patients. Adenoma detection rate (ADR) was calculated at 25.7 % for screening colonoscopies. Polyp retrieval rate was calculated at 89.1 %. ADR did not improve when colonoscopy was performed by an expert endoscopist compared to being performed by a trainee in the presence of an expert.

Conclusions Despite advances in endoscopy and bowel preparation regimes, internationally recommended colonoscopy quality performance measures are marginally pursued in every day clinical practice.

Citation Konstantakis C, Lourida T, Diamantopoulou G et al. eP134 KEY PERFORMANCE MEASURES FOR LOWER GASTROINTESTINAL ENDOSCOPY IN A TERTIARY CENTER. Endoscopy 2021; 53: S141.

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Artikel online veröffentlicht:
19. März 2021