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Adenoma detection rate is not influenced by full-day blocks, time, or modified queue position

2012; Elsevier BV; Volume: 75; Issue: 4 Linguagem: Inglês

10.1016/j.gie.2011.12.008

1097-6779

Einar Lurix, Adrían V. Hernández, Matthew N. Thoma, Fernando Castro,

Pancreatic and Hepatic Oncology Research

Background Recent studies have shown the adenoma detection rate (ADR) to decrease from endoscopist fatigue. Objective Our primary objective was to evaluate the afternoon ADR in half-day versus full-day blocks. Secondary objectives were to determine whether time or complexity of prior procedures (modified queue position) influence ADR. Design Retrospective chart review on consecutive colonoscopies. Setting Tertiary-care teaching hospital. Patients This study involved all patients in our database who were over age 45 and who underwent screening and surveillance colonoscopies. Main Outcome Measurement ADR. Results A total of 3085 patients were included in the study, with an overall 31% ADR. Of these procedures, 2148 (70%) were done in the morning, and 937 (30%) were done in the afternoon (512 full-day block, 425 half-day block). By multivariate analysis, there was no difference in ADR between full-day blocks compared with afternoon-only blocks (35% vs 32%; odds ratio [OR] 1.1; 95% confidence interval [CI], 0.8-1.5; P = .2). For all afternoon colonoscopies, no decrease in ADR was noted with increasing queue position ( P = .9) or time ( P = .3). In addition, no difference was found comparing ADR between all afternoon colonoscopies versus morning colonoscopies (33% vs 30%; OR 1.1; CI, 1.0-1.3; P = .1). No difference was found for advanced adenomas and number of adenomas between either afternoon-only blocks versus afternoon colonoscopy in full-day blocks or morning versus all afternoon cases. Limitations Retrospective study; not all withdrawal times were recorded; trainees performed some of the procedures. Conclusion Our data show that colonoscopy can be performed in full-day blocks and 30-minute slots without compromising ADR.