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Quality indicators in pediatric colonoscopy in a low-volume center:Implications for training

World Journal of Gastroenterology 2018年第9期24卷 1013-1021页

作者： Way-Seah Lee Chun-Wei Tee Zhong-Lin Koay Tat-Seng Wong Fatimah Zahraq Hee-Wei Foo Sik-Yong Ong Shin-Yee Wong Ruey-Terng Ng Department of Paediatrics University Malaya Medical CentreKuala Lumpur 59100Malaysia Paediatric and Child Health Research Group University MalayaKuala Lumpur 50603Malaysia

AIM To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center.METHODS We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years(January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks.RESULTS Median(± SD) age of 121 children [males = 74(61.2%)] who had 177 colonoscopies was 7.0(± 4.6) years. On average, 30 colonoscopies were performed each year(range: 19-58). Except for investigations of abdominal pain(21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient(0.6%) with severe Crohn's disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease(IBD) than non-IBD(72.9% vs 50.0%; P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%.CONCLUSION Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement.

关键词： Pediatric colonoscopies Quality indicators Performance

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New device to implement the adenoma detection rate

引用

World Journal of Clinical Cases 2017年第7期5卷 258-263页

作者： Maddalena Zippi Wandong Hong Pietro Crispino Giampiero Traversa Unit of Gastroen- terology and Digestive Endoscopy Sandro Pertini Hospital Department of Gastroenterology and Hepato- logy First Affiliated Hospital of Wenzhou Medical University Unit of Medicine and Urgency San Giovanni Hospital

It is well-known that colonoscopy is considered the gold standard for colon cancer prevention.Although performed by experienced endoscopists,the matter remains of polyps missed during this examination.The reasons may include the size,shape and location of the lesions.Many colorectal cancer screening programs have been proposed to increase the adenoma detection rate.The substantial difference between these methods is whether the improvement in vision,particularly the detection of irregularities of the mucosa,is inside the endoscope electronic components(magnification,wideangle vision,narrow band imaging,flexible spectral imaging colour enhancement,i-Scan) or outside the same,by the use of specific caps(EndoC uff,EndoV ision,Endo Rings).Endocuff is a plastic device mounted at the end of the scope with a constant vision field of the entire colon.The aim of this study is to explore the potential clinical and technical benefits of Endocuff.

关键词： Adenoma detection rate Cap-assisted colonoscopy Colorectal cancer Endocuff-assisted colonoscopy Standard colonoscopies

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