Keeping Up with Colonoscopy Standards - A Challenge for the Non-Colorectal General Surgeon?

Abstract

Introduction: The recent Guidelines for the Implementation of a National Quality Assurance Programme in GI Endoscopy published by the RCPI/RCSI in October 2010 stipulate the minimum standards expected in endoscopy practice. This study aims to compare advised standards to current practice in our institution compare any differences in performance amongst colorectal versus non-colorectal, general surgeons. Materials and methods: Data of patients undergoing colonoscopy performed by surgeons (January 2010 - December 2011) was attained from our prospectively maintained database. Results: Of 806 colonoscopies, mean age was 60.1 years. In the colorectal versus non- colorectal group, caecal intubation was 95.4% versus 75.1% (p<0.001) and polyp retrieval was 94.0% versus 87.3% (p<0.001) respectively. Conclusion: This is the first study to highlight the discrepancy of standards between colorectal and non-colorectal surgeons for colonoscopy. Overall, current practice did not fully adhere to the minimum standards of the proposed guidelines. However, this was particularly evident in the non-colorectal group. Caecal intubation rates were greater than 95% in the colorectal group which was not the case for the non-colorectal group. This study suggests that colonoscopy should be done exclusively by colorectal surgeons along with medical gastroenterologists or perhaps focused training is required for the non-colorectal surgeon to help them adhere to proposed standards.