Colonoscopy an Audit: Wiser the Decision Better the Outcome

Abstract

Background and Aim of the Study: In a developing country like India, wherein routine screening colonoscopy is not a norm and prevalence of colonic polyps is considered to be rare, we conducted a study to analyse the indications, findings and our compliance with selected key performance indicators (KPI’s): Cecal intubation, polyp detection rate, colonoscopy withdrawal time, adverse events and bowel preparation at a large tertiary care hospital in Bengaluru, India which would aid in improving the quality of our practice. Materials and Methods: A retrospective study was conducted on 185 patients either admitted or seen on outpatient basis at Bowring and Lady Curzon hospital attached to Bangalore medical college and research institute (BMCRI), Bengaluru. The colonoscopy reports of all patients at our center from September 2017 to August 2018 were reviewed to obtain information on demographics, indications, findings and KPI’s and the data was analyzed using appropriate statistical methods. Results: Among 185 patients who underwent colonoscopy 63% were male and 53% were 31-59 years old. The major indications were bleeding per rectum (PR) [24%], colonic wall thickening on imaging(19%), chronic diarrhea (11%) and colorectal growth (8%). 82% of the patients had excellent bowel preparation with the cecal intubation achieved in 84%.The common pathological findings in the above mentioned indications were Colorectal cancer(CRC) [11%], ulcer(9%), Inflammatory bowel disease(IBD) [6%] and polyp(6%). Conclusions: Colonoscopy is very much essential to evaluate lower GI symptoms. The quality of practice lies on the bowel preparation as well as cecal intubation. Bleeding PR was the most common indication whereas colorectal cancer was the most common pathological finding although more than half of the examinations were normal.