Document Detail

Trainees' adenoma detection rate is higher if ≥ 10 minutes is spent on withdrawal during colonoscopy.
MedLine Citation:
PMID:  22083333     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It has been demonstrated that prolonged colonoscopic withdrawal times (WT; >6 min) are beneficial for the adenoma detection rate (ADR) for experienced endoscopists. There are little data, however, to guide the appropriate colonoscopic withdrawal times for trainees. The purpose of this study was to determine whether there is a relationship between WTs and ADR for first-year fellows training in colonoscopy.
METHODS: This is a prospective study of first-year gastroenterology fellows at a single academic teaching hospital who documented each colonoscopy with a self-report form over the course of an academic year (March 2010 to February 2011). The internal policy for the trainees was to have at least a 6-min withdrawal time for each colonoscopy.
RESULTS: Four first-year fellows in gastroenterology at an academic medical center completed self-reports for 1,210 colonoscopies. Mean WT was 10.2 ± 3.4 min. The aggregate polyp detection rate was 33.2% and the aggregate ADR was 22.3%. For colonoscopies with WT < 10 min, ADR was 9.5%, and for colonoscopies with WT ≥ 10 min, ADR was 32.3% (p < 0.001). When the quality indicator of 25% goal ADR for males and 15% goal ADR for females is applied, this aggregate rate is achieved for both sexes for screening colonoscopies (n = 676) with WT ≥ 10 min.
CONCLUSIONS: First-year trainees had a significantly higher ADR if their colonoscopic WT is ≥ 10 min.
Mark A Gromski; Christopher A Miller; Suck-Ho Lee; Eun Seo Park; Tae Hoon Lee; Sang-Heum Park; Il-Kwun Chung; Sun-Joo Kim; Young Hwangbo
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Publication Detail:
Type:  Journal Article     Date:  2011-11-16
Journal Detail:
Title:  Surgical endoscopy     Volume:  26     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-24     Completed Date:  2012-07-09     Revised Date:  2013-07-08    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1337-42     Citation Subset:  IM    
Division of Gastroenterology, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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MeSH Terms
Adenoma / diagnosis*
Clinical Competence / standards*
Colonic Neoplasms / diagnosis*
Colonoscopy / education,  standards*
Early Detection of Cancer
Education, Medical, Graduate*
Gastroenterology / education*
Middle Aged
Prospective Studies
Time Factors
Comment In:
Surg Endosc. 2013 Jun;27(6):2243-4   [PMID:  23292564 ]
Surg Endosc. 2013 Jun;27(6):2245-6   [PMID:  23292565 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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