Optimizing Colonoscopy Efficiency: A Time-Based Analysis of Procedural Metrics in Tunisia

Aims Colonoscopy withdrawal time is a critical quality indicator for effective colorectal cancer screening. This study aims to analyze withdrawal times and overall time allocation in colonoscopy procedures at a Tunisian hospital, with a focus on the impact of endoscopist experience.

Methods A prospective study was conducted on 2,022 colonoscopies performed at a tertiary care center in Tunisia. Withdrawal times were categorized as<6 minutes,≥6 minutes, and≥8 minutes. The relationship between withdrawal time and endoscopist experience, measured by years of practice, was assessed. Overall time allocation for each stage of the colonoscopy procedure was also evaluated.

Results The mean total allocated time for colonoscopy procedures was 45±15 minutes. Withdrawal time of≥6 minutes was observed in 98.4% (1,990/2,022) of procedures, with 38.5% lasting≥8 minutes. Only 2.2% of procedures had withdrawal times<6 minutes. Endoscopist experience significantly influenced withdrawal time (p=0.032). Endoscopists with≥30 years of experience achieved≥6-minute withdrawal times in 99.3% of cases, compared to 97.5% for those with<5 years of experience and 98.9% for those with 5-30 years of experience. The time allocation analysis revealed that the mean time spent on insertion was 11±6 minutes, the mean withdrawal time was 14±6 minutes, and the mean time spent on overall procedure completion was 20±9 minutes.

Conclusions Our study demonstrates a high adherence to the recommended≥6-minute withdrawal time in our hospital, with a notable proportion of procedures exceeding 8 minutes. Endoscopist experience positively correlates with longer withdrawal times, suggesting a potential area for targeted training to optimize colonoscopy quality. The allocated procedure time of 45±15 minutes appears sufficient for maintaining these standards. Further research is needed to correlate these time metrics with adenoma detection rates, cancer detection, and long-term patient outcomes. Implementing regular monitoring and feedback on withdrawal time performance may help sustain and improve colonoscopy quality in this setting.

Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025