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Published on: October 17, 2013
Successful pancolonoscopy and ileoscopy in children
D M Israel1, B I McLain, E Hassall
1Division of Gastroenterology, British Columbia Children's Hospital, Vancouver, Canada.
Insights
Pediatric gastroenterology fellows achieved high success rates in pancolonoscopy, with completion rates reaching 97% for the cecum and 95% for the terminal ileum when excluding difficult cases. Procedure duration varied by operator experience.
Area of Science:
- Pediatric Gastroenterology
- Endoscopy
- Medical Training
Background:
- Pancolonoscopy is crucial for diagnosing pediatric gastrointestinal conditions.
- Assessing the quality and efficiency of procedures performed by trainees is essential for medical education.
Purpose of the Study:
- To prospectively evaluate the quality, extent, and duration of pediatric pancolonoscopy.
- To compare procedural outcomes between pediatric gastroenterology attending physicians and fellows in training.
Main Methods:
- Prospective data collection over 7 months on 40 pediatric pancolonoscopy procedures.
- Analysis of cecal and terminal ileum intubation rates, procedure duration, and operator involvement.
- Exclusion of cases with strictures and equipment failure to determine optimal completion rates.
Main Results:
- Cecal intubation was achieved in 92.5% and terminal ileum in 87.5% of cases.
- Excluding challenging cases, completion rates improved to 97% (cecum) and 95% (terminal ileum).
- Average procedure duration was 38 minutes, with attending physicians averaging 31 minutes and fellows 37 minutes (when completing independently).
Conclusions:
- Pediatric gastroenterology fellows demonstrate proficiency in pancolonoscopy, with high success rates comparable to attending physicians.
- Fellows' independence in performing procedures increased over the study period.
- The study provides valuable data on the learning curve and efficiency of fellows in pediatric pancolonoscopy.
Abstract:
The purpose of this study was to collect prospective data regarding the quality, extent, and duration of pediatric pancolonoscopy performed by pediatric gastroenterology attending physicians and a fellow in training. Over 7 months, data were prospectively collected on 40 colonoscopic procedures. The cecum was reached in 37 cases (92.5%) and the terminal ileum in 35 cases (87.5%). When cases of stricture and equipment failure were excluded, these completion rates were 97 and 95%, respectively. The overall average duration for pancolonoscopy, ileoscopy, multiple biopsies, and polypectomy (where necessary) was 38 min. When attending physicians performed the procedure, the duration was 31 min; the duration was 37 min when the fellow completed the procedure and 45 min when the fellow required the attending physician to complete it. The average time taken to reach the cecum by the attending physician was 19 min (range, 8-32); by the fellow it was 25 min (range, 17-32), and by the combination it was 37 min (range, 11-59). The average time from cecum to terminal ileum was 3 min for all, with ranges of 1-12 min for the attending physician and 1-23 min for the fellow. The fellow initiated 24 procedures, of which the attending physician was required to complete 12, including all five procedures performed in the initial 2 months of the study, 7 of 13 in the next 3 months, and none of the six procedures in the last 2 months. Of the 40 examinations, the colon was normal in five (12.5%), and a specific diagnosis was made in 35.(ABSTRACT TRUNCATED AT 250 WORDS)
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