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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Endoscopic Procedures II: Colonoscopy01:25

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

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Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
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Endoscopic Procedures III: Video Capsule Endoscopy01:28

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Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
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Choosing Your Endoscopist: A Retrospective Single-Centre Cohort Study.

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  • 1General Surgery, St. John of God Midland Public and Private Hospitals, Perth, AUS.

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Gastroenterologists achieved higher colonoscopy quality metrics than surgeons, including adenoma detection rates. Optimizing withdrawal times and documentation can improve colonoscopy outcomes for all specialists.

Keywords:
adenoma detection ratecolonoscopycolorectal cancerquality improvementsurveillance

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Area of Science:

  • Gastroenterology and General Surgery
  • Medical Performance Benchmarking
  • Colorectal Cancer Screening and Diagnosis

Background:

  • Colorectal cancer is a leading malignancy in Australia, with colonoscopy being a key diagnostic tool.
  • Colonoscopies are performed by various specialists, primarily general surgeons and gastroenterologists.
  • Analyzing performance differences between specialties can enhance service quality and patient outcomes.

Purpose of the Study:

  • To compare colonoscopy performance indicators between general surgeons and gastroenterologists.
  • To identify inter-specialty differences in key procedural metrics and adenoma detection.
  • To provide insights for improving colonoscopy quality and patient care.

Main Methods:

  • A retrospective cohort study of 2086 patients undergoing colonoscopies between July 2021 and June 2023.
  • Comparison of primary outcomes: caecal intubation rates (CIR), photo documentation rates (PDR), documented withdrawal rates (DWR), withdrawal times (WT), and adenoma detection rates (ADR).
  • Analysis of secondary outcomes including adenoma frequency, optimal WT, and indications for colonoscopy.

Main Results:

  • Gastroenterologists demonstrated significantly higher CIR (99% vs 94.9%), PDR (99.1% vs 95.9%), DWR (87.3% vs 17.4%), WT >6 min (97.8% vs 82.3%), and ADR (59.7% vs 37.9%) compared to surgeons.
  • Optimal withdrawal time was identified as ≥9 minutes, associated with higher adenoma detection.
  • Specialty indications differed: surgeons for surveillance and rectal bleeding, gastroenterologists for bowel symptoms and polyp surveillance.

Conclusions:

  • Significant performance differences exist between surgeons and gastroenterologists in colonoscopy quality indicators, despite both exceeding national benchmarks.
  • Adenoma detection rate disparities may be linked to differing patient indications for colonoscopy.
  • Increasing withdrawal times to ≥9 minutes and improving documentation practices are recommended to enhance adenoma detection and procedural quality.