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Colonoscopy: why are general surgeons being excluded?

A Mehran1, P Jaffe, J Efron

  • 1Department of Surgery, Cleveland Clinic Florida, 6101 Pine Ridge Road, Naples, FL 34119, USA.

Surgical Endoscopy
|October 22, 2003
PubMed
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General surgeons perform colonoscopies efficiently and safely, matching gastroenterologists and colorectal surgeons in outcomes. This study supports including general surgeons in endoscopy suites.

Area of Science:

  • Gastroenterology
  • Surgical Endoscopy
  • Colorectal Surgery

Background:

  • The role of surgeons in performing colonoscopies is debated, with varying standards for endoscopy privileges often biased against general surgeons.
  • Conflicting literature exists regarding the safety and efficacy of surgeons performing colonoscopies.

Purpose of the Study:

  • To evaluate and compare colonoscopy outcomes between gastroenterologists (GI), general surgeons (GS), and colorectal surgeons (CRS).
  • To assess procedure times, complication rates, and cecal intubation rates across the three groups.

Main Methods:

  • A retrospective review of 5237 colonoscopies performed between January 2000 and July 2002.
  • Data collected prospectively included procedure times, completion rates, and complications (perforation, bleeding, postpolypectomy syndrome).

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  • Statistical analysis involved Chi-squared tests for rates and Kruskal-Wallis/Dunn's tests for median procedure times.

    • Main Results:

    • No significant differences in complication rates were observed among GI (0.12%), CRS (0.15%), and GS (0.11%) groups (p=0.99).
    • A trend towards lower incomplete colonoscopy rates was noted in the GS group (0.32%) compared to CRS (0.84%) and GI (0.36%) (p=0.07).
    • Median colonoscopy times were significantly shorter for GS (29 min) compared to GI (34 min) and CRS (31 min) (p<0.001).

    Conclusions:

    • General surgeons demonstrate comparable safety and efficacy in performing colonoscopies to gastroenterologists and colorectal surgeons.
    • General surgeons perform colonoscopies more expeditiously with similar low morbidity and high completion rates.
    • The findings support the inclusion of general surgeons in endoscopy suites without exclusion.