Quality indicators in pediatric colonoscopy: an Australian tertiary center experience
| Autor: | Looi C Ee, Geoffrey D. Withers, Harveen Singh |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Abdominal pain Adolescent Colorectal cancer medicine.medical_treatment Biopsy Colonoscopy Inflammatory bowel disease Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Intubation Humans Child Intubation Gastrointestinal Quality Indicators Health Care Retrospective Studies High rate medicine.diagnostic_test business.industry General surgery Gastroenterology Cecal intubation Australia Infant medicine.disease Hospitals Pediatric Logistic Models Colorectal cancer screening Child Preschool Multivariate Analysis 030211 gastroenterology & hepatology Female medicine.symptom business |
| Zdroj: | Scandinavian journal of gastroenterology. 52(12) |
| ISSN: | 1502-7708 |
| Popis: | Quality indicators for colonoscopy in adults are largely driven by colorectal cancer screening, and include cecal intubation rates, with rates of90% recommended. In contrast, colorectal cancer is rare in childhood, with paucity of data on relevant quality indicators for pediatric colonoscopy. It is also unclear whether high rates of cecal intubation are achievable in small children. Our aim was to audit all colonoscopies performed in a tertiary pediatric center to examine clinical indications for procedure, completeness of examination with cecal and ileal intubation, significant findings, and complications.Retrospective review of colonoscopies performed between November 2011 and October 2015 was undertaken.Total colonoscopy was performed in 652 patients, 53% male, with median age 13.0 (range 0.4-18.2) years. The most common indications for colonoscopy were assessment of inflammatory bowel disease (IBD) 57.9% (378/652), rectal bleeding 10% (68/652) and abdominal pain 10% (68/652). Trainees performed 69.8% (452/652) of procedures. Quality of bowel preparation was mentioned in 63% (410/652), of which 22% (90/410) were considered inadequate. Cecal intubation rate was 96.3% (628/652) and ileal intubation rate was 92.4% (603/652). Extent of procedure was confirmed in 99.2% of patients with photographs and/or ileal biopsy. Poor quality of bowel preparation (p = .001) and age5years (p = .007) were inversely related to successful ileal intubation.High rates of cecal and ileal intubation are achievable in pediatric colonoscopy. Ileal intubation should be considered a quality indicator since the main indicator for pediatric colonoscopy is to investigate IBD. |
| Databáze: | OpenAIRE |
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