26th October 2018, Volume 131 Number 1484

Mehul Lamba, Steven Ding

Gastrointestinal (GI) endoscopy is playing an ever-increasing role in the management of GI disorders. Colonoscopy is one of the most effective tools in screening for colorectal carcinoma (CRC), hence there…

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Summary

This is an independently conducted audit of safety and quality of colonoscopy service offered at Charity hospital, Christchurch, and the quality indicators were compared against the current international standards. Complying with quality indicators is important, as it has been shown to improve diagnosis of polyps (precancerous lesions) at colonoscopy. This study showed that colonoscopies performed during one year at the charity hospital were of high quality and met internationally accepted quality indicators. It also provides confidence that it is possible to provide colonoscopy service of high standard in smaller peripheral centres like the Charity hospital, instead of the public hospitals, supporting a trend that has been seen in the North American countries over the last several years.

Abstract

Aim

To perform an independent review of the quality and safety of colonoscopy service at the Canterbury Charity Hospital (CCH).

Method

Demographic, endoscopy and histology data on all colonoscopies performed at CCH between 1 October 2016 and 31 September 2017 were collected. Quality indicators ascertained were caecal intubation rate, mean withdrawal time and adenoma detection rate (ADR). These were assessed using current recommendations by the Joint American College of Gastroenterology and American Society of Gastrointestinal Endoscopy task force.

Results

Thirty-four patients, mean age 44 years (range 21–62), underwent colonoscopy. The most common indications were rectal bleeding and/or altered bowel habit (19 patients). Eight asymptomatic patients underwent colonoscopy because of a family history of CRC or a personal history of colorectal polyps; six of these were over 50 years old. Twelve patients had haemorrhoids and seven patients had adenomatous polyps. The caecal intubation rate was 97.1%. Among asymptomatic patients over 50 years undergoing colonoscopy, mean withdrawal time was 7.5 minutes (range 5–10) and ADR was 33.3%. No complications were recorded.

Conclusion

The colonoscopy service at CCH was safe and complied with the accepted quality indicators. Our data suggest that delivery of high-quality colonoscopy services might be possible in similar peripheral and day hospitals around New Zealand. Increasing colonoscopy services in such centres would reduce the excessive workload of larger public hospitals and reduce the level of unmet need for colonoscopy services.

Author Information

Mehul Lamba, Registrar, Gastroenterology, Christchurch Hospital, Christchurch; 
Steven Ding, Gastroenterology, Christchurch Hospital, Christchurch.

Acknowledgements

Colonoscopies in this study were performed by P Bagshaw and I Kolossa, volunteer specialist surgeons working at the Canterbury Charity Hospital.

Correspondence

Dr Mehul Lamba, Registrar, Gastroenterology, Christchurch Hospital, 2 Riccarton Ave, Christchurch 8025.

Correspondence Email

mehullamba@gmail.com

Competing Interests

Nil.

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