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At least 379 records · Page 21Linked to original sources
PubMed2006

Quality assessment of colonoscopic cecal intubation: an analysis of 6 years of continuous practice at a university hospital.

BACKGROUND: Despite increased emphasis on endoscopic performance indicators, e.g., cecal intubation rates, limited data from actual clinical practice have been published. OBJECTIVES: Retrospective database review to determine the rate and documentation of cecal intubation during colonoscopy at the University of Maryland Medical Center. METHODS: We reviewed 5,477 consecutive colonoscopies performed by 10 faculty gastroenterologists at a University hospital over a 6-yr period (March 1, 1999 to February 28, 2005). Unadjusted cecal intubation rates were analyzed as were rates that were adjusted based on the U.S. Multi-Society Task Force on Colorectal Cancer recommendations. We analyzed trends in overall and individual cecal intubation rates, circumstances that impact these rates, and the quality of documentation of cecal intubation. RESULTS: The overall adjusted cecal intubation rate for the entire 6 yr was 90.3%, and increased over the study period with the highest adjusted rate (93.7%) in the most recent year studied. There was no correlation between cecal intubation rate and patient age, gastroenterology fellow involvement, or endoscopist experience and number of procedures/year. In contrast, colon cancer screening, male gender, outpatient colonoscopy, and adequate bowel preparation predicted a higher cecal intubation rate. Written and photographic documentation of cecal intubation improved significantly after 2002. CONCLUSIONS: Our analysis revealed cecal intubation and documentation rates that meet current guidelines, and identified factors that may cause substantial variance in these rates depending on the nature of the practice. The present analysis confirms that computerized databases can be used to assess individual and group cecal intubation and documentation rates on an annual basis, and to make these data available to the public.

Aged↗
PubMedDate not supplied

[Advantages and limits of rigid rectosigmoidoscope and flexible colonoscope in childhood].

During the past ten years 220 pediatric proctosigmoidoscopies with the rigid instrument in 182 infants and children, and 71 colonoscopies in 62, were performed. Advantages and limits of these two instruments are discussed. The indications and results of the different procedures are presented. Positive diagnoses were obtained in 81% with both techniques while the histological examination was positive in 85% of specimens obtained by colonoscopy and only in 51% of the proctosigmoidoscopical ones. Colonoscopy has increasingly became a complementary method for colonic pathology in children, in comparison with adult medicine, however, pediatric indications have been handled mostly with the shorter instrument for two main reasons: 1) Pediatric colonic pathology affects predominantely the lower tract; 2) Neoplastic lesions, in which total colonoscopy with biopies at different levels is mandatory, are extremely rare in children.

Adolescent↗
PubMedDate not supplied

[Pediatric colonoscopic polypectomy].

Colorectal polyps are relatively frequent in infancy and constitute one of the main causes of bleeding per rectum. Endoscopic polypectomy, with its lower morbidity and mortality, has revolutionized its treatment. Between October 1, 1985 and May 31, 1994, 122 polypectomies were done in 88 pediatric patients. Forty five patients (51.1%) were male and 43 female (48.9%). Forty four patients (50%) were between 1 and 5 years of age. Ninety five polyps (77.9%) were found more frequently in the rectum. Regarding the size, 63 polyps (51.6%) measured between 1 and 2 cm. Seventy three patients (83%) had a single polyp, 10 patients (11.4%) had 2 polyps and 1 patient had 12 polyps. Ninety six polyps (78.7%) were pedunculated, being this the more frequent form found. Histologically the most common was the juvenile polyp, found in 106 cases (87.6%). The polypectomies was carried out without using general anesthesia and is performed as an outpatient procedure. We had no experience of endoscopic complications. It is concluded that colonoscopy polypectomy is a useful, simple and safe procedure for treating colorectal polyps in children.

Adolescent↗