Prospective audit of colonoscopy quality

Aim: To evaluate the quality of colonoscopies performed in the Endoscopy Unit of First Department of Medicine, University of Pécs.

Methods: The quality of colon preparation, the cecal intubation rates, intubation and withdrawal times were recorded during the procedures. The cecal intubation rates were calculated, and the detection of adenomas and tumors were also noted. The indication of the procedure was also analyzed according to the ASGE recommendation.

Results: 200 consecutive procedures were audited in February and March, 2009. The patient's age was between 17 and 88 years (mean: 59.8 years, 79% of the patients were 50 years old or older). The cecal intubation rate was 87.6% (intention-to-treat basis), 2.6% of the patients had significant stenosis, 4.6% had inappropriate preparation what interfered with the complete colonoscopy. The average cecal intubation time was 10.7min (2–27min), while the withdrawal time was 9.4min (3–28min). The withdrawal time was less than 6min in 9% of the cases. Adenomas were detected in 34.5% of the procedures, while tumors were detected in 9.5% of the patients. The adenoma detection rate in persons aged 50 years or older was 41.1%. No immediate and one late complication (postpolypectomy coagulation syndrome) were noted during the audit. The indication was screening in 45.5%, occult or manifest bleeding in 29.5%, inflammatory bowel disease in 7.5%, abnormal findings of imaging modalities in 7.5%, chronic diarrhea in 6.5%. Abdominal pain at age below 50 years was the indication in 3.5% of the cases which is not part of the ASGE recommendation.

Conclusions: The main quality indicators of colonoscopy met with the recommended standards in our laboratory. These quality indicators can be easily recorded before and during the procedures by applying a simple checklist. Ideally this parameters should be part of the endoscopy report.