Clinical Medicine Insights: Gastroenterology

Rita Slim, Louisa Khairallah, César Yaghi, Khalil Honein, Marwan Chemaly, Bahaa Kheir and Raymond Sayegh

Service de gastro-entérologie, HDF.

Abstract

Background: Colonoscopy has a great impact on diagnosis and management of the diseases of the colon. In general it’s a safe and accurate procedure. No evaluation has been done of any endoscopic practices in a country where the practice of medicine is totally private.

Objectives: Prospective audit of technical success and complication rates of both therapeutic and diagnostic colonoscopy.

Setting: One endoscopy unit of a Lebanese university hospital.

Patients and design: 407 consecutive colonoscopies were evaluated over a 6-month period. Data were recorded for age and sex of the patients, indication of the colonoscopy, presence of comorbidities, patients risk stratification, administrated dose of anesthetic drugs. Data concerning the procedure itself were also monitored.

Intervention: Completion rate as well as complications reported during or post colonoscopy. All patients were called back by phone 48 hours and 1 month later to identify any related post-procedural complication.

Results: 407 patients underwent colonoscopy. All patients were sedated with midazolam, propofol and fentanyl. The overall caecal intubation rate was 99.99%. 70 snare polypectomies and 29 cold forceps excision were performed as well as 5 coagulations with Argon Plasma Coagulation. The most important post-procedural complication was chemical colitis in 2 cases.

Limitations: Patients and endoscopists satisfaction was not evaluated. It’s an audit of a single tertiary French affiliated hospital. It does not necessarily reflect what’s really happening on a national level.

Conclusion: This audit enabled us to change some of our practices; i.e. rinsing method of endoscopes. It stimulated the team to keep a high performance level without neglecting the risk of potential complications.