Colonoscopy quality indicators in patients with and without prior colonic resection: A single-centre prospective...

Area of Science:

• Gastroenterology
• Endoscopy
• Quality Improvement

Background:

• Effective colonoscopy requires adherence to quality control thresholds.
• Previous studies on colonoscopy key performance indicators (KPIs) have often excluded patients with a history of colonic resection (nonintact colons).
• Patients with nonintact colons also require high-quality colonoscopic examinations.

Purpose of the Study:

• To compare colonoscopy KPIs between patients with nonintact and intact colons.
• To evaluate the impact of including nonintact colonoscopies on overall quality metrics.
• To advocate for the inclusion of nonintact colonoscopy data in performance reports.

Main Methods:

• A retrospective analysis of consecutive colonoscopies performed between September 2016 and March 2020 at Whanganui Hospital, New Zealand.
• Comparison of primary outcome: caecal or ileal intubation rate (CIIR).
• Comparison of secondary outcomes: adenoma detection rate (ADR), polyp detection rate (PDR), colonoscope withdrawal time (CWT), and caecal or ileal intubation time (CIIT).

Main Results:

• A total of 3017 colonoscopies were analyzed (322 nonintact, 2695 intact colons).
• Caecal or ileal intubation rate (CIIR) was significantly higher in nonintact (98.4%) versus intact colons (95.0%).
• Adenoma detection rate (ADR) and polyp detection rate (PDR) were similar between groups, while withdrawal and intubation times were shorter for nonintact colons.

Conclusions:

• The caecal or ileal intubation rate (CIIR) in nonintact colons exceeded recommended targets.
• Adenoma and polyp detection rates were comparable, indicating similar efficacy despite shorter procedure times in nonintact colons.
• Including patients with nonintact colons in quality assessments is crucial for ensuring high-quality colonoscopy for all patients.