Quality of Colonoscopy, Characteristics of Polyps/Adenomas and Adenoma Detection Rate: A Cross Sectional Study
DOI:
https://doi.org/10.51253/pafmj.v76i1.12788Keywords:
Adenoma detection rate, Bowel preparation, Colonoscopy, Polyp detection rate, Polyp morphology, Quality indicatorsAbstract
Objective: To evaluate the quality of colonoscopy procedure and assess characteristics of polyps/adenomas and their detection rate.
Study Design: Cross Sectional Study.
Place and Duration of Study: Department of Gastroenterology, Combined Military Hospital, Rawalpindi Pakistan, from Jan 22 to Dec 23.
Methodology: Patients aged 15 to 92 years were included through non-probability consecutive sampling in which 387 colonoscopies were performed. Quality metrics addressed included indication, bowel preparation, caecal intubation rate, withdrawal time, polyp/adenoma detection rate and adverse events. Polyp/adenoma characteristics included site, morphology, size and histology-dysplasia. Results were analyzed using SPSS.
Results: Out of 387 colonoscopies, bowel preparation was adequate in 80.6% and caecal intubation rate was 85.3%. The overall polyp detection rate (PDR) was 21.2% and adenoma detection rate (ADR) was 9.3%. The PDR and ADR in patients > 50 years old were 23.7%, and 13.9%. ADR in patients >50 years old was statistically significant (p<0.001). Bowel preparation also showed significance with PDR (p=0.041) and ADR (p=0.025). There was no significant difference of PDR in patients >50 years old and PDR/ADR with gender. The most common polyp morphology was sessile 0-Is 64.6%. Polyps of size ≥10 mm, 13.3% were more likely to be adenomas and harbor higher grade dysplasia (p<0.001).
Conclusion: PDR and ADR increase with better preparation. Increase in polyp size was associated with adenomas of advanced features. The quality indicators of colonoscopy, PDR and ADR merit further evaluation large scale multicenter validation studies are needed to define baseline characteristics and PDR, ADR in our population.
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