Is Lower GI Endoscopy Still a Problem?

Abstract

AIM: To analyze the outcome of colonoscopies performed at a local hospital.

METHODS: A retrospective review of all Lower GI endoscopies performed at Fauji Foundation Hospital Rawalpindi was conducted from November 1993 through December 2011. All aspects were analyzed to record the number, quality and appropriateness of procedures, completion rate, diagnostic and therapeutic outcome and complications reported. The reasons for failure to complete were scrutinized and recorded. The procedures were carried out as such without questioning the appropriateness of indication or otherwise.

RESULTS: A total of 1431 patients underwent Lower GI endoscopic examinations between September 1993 and October 2011. The age range was from 4 to 93 years (mean 45±18.8). There were more female patients. The overall caecal intubation rate was 42%. The incomplete procedures comprised 800 (60%). The success rate of bowel preparation was (92.8%). Rectal bleeding constituted the leading indication for colonoscopy (31%). The results were normal in (46.36%) patients. The colonoscopic diagnoses could not be obtained in 117 (8%) patients owing to poor bowel preparation. Inflammatory bowel disease was the most common diagnosis (13.98%) followed by colorectal cancer (8%). Therapeutic procedures were performed in 93 patients. The most important procedural complication was perforation in 1 case only. The overall polyp detection rate was 8% in this study.

CONCLUSION: Completion rate was 42%. Rectal bleeding was the leading indication for colonoscopy followed by chronic diarrhea and abdominal pain. Colonoscopy performed for appropriate indications yields more significant findings and avoids wastage of resources. The factors that can enhance performance at colonoscopy were proper bowel cleansing and devoting sufficient time for the examination. There is a need to develop new generation slick instruments to overcome technical difficulties.