Indications, findings, and technical performance of colonoscopies by a single general surgeon in a small rural hospital

Abstract

Context Colorectal cancer is the third leading cause of cancer-related death in the United States. Colonoscopy is a proven effective screening tool for precancerous polyps. Objective To assess indications, findings, and technical performance of colonoscopies by a single general surgeon in a rural hospital to compare with previously published literature and establish a baseline for possible future studies. Methods A retrospective chart review of patients receiving a colonoscopy from a single general surgeon from January 1, 2007 through June 11, 2009. Multiple patient factors and procedural details were recorded. Cecal intubation and adenoma detection rates were also calculated. Results A total of 313 colonoscopy procedures were recorded from 303 patients. Average age of patients was 57 ± 14; 46.3% were male. The most common reason for colonoscopy was blood loss signs and symptoms (45%, n = 141), with 31.9% of these patients having adenomatous polyps. Cecal landmarks were mentioned in all complete colonoscopies. The average cecal intubation rate was 91.3%, gradually improving from 85.3% in 2007 to 96.6% in 2009. Adenoma detection rate for patients ≥50 years of age was 30.5% overall, 34.8% for men, and 36.1% for women. Quality of bowel preparation was not mentioned in 75.7% of cases and withdrawal time was not recorded. Conclusions A successful assessment of a general surgeon performing colonoscopies in a small rural hospital setting was performed. Adenoma detection rate and cecal intubation are above the recommended guidelines by the US Multisociety Task Force on Colorectal Cancer. Documentation for withdrawal times, adequate bowel preparation, and photographic documentation of cecal landmarks were lacking. As quality improvement measures are becoming more prevalent in health care it is important to continuously evaluate performance.