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ASGE Quality Indicators for Colonoscopy

medical illustration showing a colonoscopy | GI NorthConferring to WebMD, a colonoscopy is a test that enables a physician to view the inner lining of your large intestine (colon and rectum). The test involves a colonoscope to allow inspection of the colon, which is a pliable and thin tube that is around 48 in. (125 cm) to 72 in. (183 cm) long. In fact, a physician can inspect the whole colon and the lower part of the small intestine with the use of the device.

Moreover, the test aids in finding tumors, ulcers, polyps and areas of bleeding or inflammation. The biopsy can involve collecting tissue and the removal of abnormal growths. As well, a colonoscopy can help with screening for cancer or pre-cancerous growths in the rectum or colon.

ASGE Quality Indicators

One of the chief priorities for the nation’s prominent gastrointestinal endoscopic healthcare association is identifying quality standards and defining measurements in administering colonoscopic care. As of late, the American Society for Gastrointestinal Endoscopy or ASGE identified objective processes in relation to colonoscopy (April 2006). In fact, the measurements and guidelines greatly assist endoscopists with assessing and refining their performance.

Effective colonoscopy entails thorough and cautious mucosal inspection so that the cancer mortality is lowered and colon cancer is prevented. ASGE quality indicators are used to measure the performance of colonoscopy so that a better outcome is achieved. It also rates the level of evidence in support of each quality indicator. For the three stages of a colonoscopy there are quality indicators: Preprocedure, Intraprocedure and Postprocedure.

Preprocedure

The preprocedure quality indicators for colonoscopy include numerous concerns that impact the patient and endoscopic team. Prior to admin of insertion or sedation of the endoscope, these common issues are taken into consideration.

  • Correct Indications – Once information is obtained or the therapy delivered will help the patient, endoscopy is indicated.
  • Informed Consent – Consent and approval is first acquired and documented for the procedure. As well, analgesia and sedations are provided except in emergency situations. Approval and consent should include common complications such as perforation, bleeding, sedation-related complications and missed diagnosis.
  • Preparation – It is essential that there be impeccable documentation of the quality of the bowel preparation so that screening is successful. Measures for precision should include poor, fair and excellent.

Intraprocedure

The intraprocedure quality indicators are comprised of three main areas: Cecal intubation, detection of adenomas and withdrawal time.

Cecal intubation – The visualization of the cecum by noting the landmarks and the photo-documentation of landmarks should always be documented in each procedure. As well, the entire cecal caput that includes the medial wall of the cecum between the ileocecal valve and appendiceal orifice should be visible. The necessity for cecal intubation is established by the continual finding that contains a significant fraction of colorectal neoplasms located in the proximal colon as well as the cecum. Moreover, visualization of this area is vital for preventing colon cancer.

Detection of adenomas – Expertise is critical when it comes to the finding of adenomatous polyps (benign premalignant tumors) in asymptomatic patients that are undertaking screening colonoscopy. In fact, studies indicate that the colonoscopy discoveries by gastroenterologists and endoscopists are much more accurate that the tests done by non-gastroenterologists or interns. Plus, there is a top-quality examination of colonic distention, mucosa proximal to folds and flexures and superior cleaning of fluid and debris from the colon.

Withdrawal time – The total time spent inspecting the colon while removing the colonoscope can be a fitting quality indicator. Actually, longer times are connected with larger findings of neoplastic lesions. In fact, prevalence rates of adenomas in screening are greater than 25% in men and 15% in women over 50 years old. What is more, doctors who spend more than six minutes of withdrawal time had a much higher detection rate of adenomas compared to those who had less than a six minute average.

Other intraprocedure regions consist of patients going through ulcerative colitis, biopsy samples from patients with chronic diarrhea and Crohn’s disease analysis.

GI North

If you suspect that you may have any kind of colon issues it is always best to schedule an appointment with a specialist. In fact, you can set up a one-on-one appointment at GI North to talk over any specific treatment or procedure you may be contemplating. Both Dr. Cofrancesco and Dr. Quijano are renowned for their expertise and experience. As well, Dr. Quijano fluently speaks Spanish.

GI North is located in Cumming, GA and also serves the surrounding areas: Alpharetta, Canton, Roswell and Suwanee.

© 2016 GI North Gastroenterology Services. All rights reserved.

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