Recent studies have shown that colonoscopic polyp detection decreases as the workday
progresses. This may reflect time-dependent factors such as colonoscopist fatigue
and decreased colon cleanliness, which can be addressed through adaptations in colonoscopy
practice.
To test for time-of-day differences in adenomatous polyp (AP) and sessile serrated
polyp (SSP) detection in a practice that uses split-dose bowel preparation and moderated
daily colonoscopist procedure loads.
Retrospective chart review.
Community-based, group gastroenterology practice.
This study involved 2439 patients undergoing surveillance or screening colonoscopy.
Colonoscopy.
Detection rate of all premalignant polyps (PMPs), and of APs and SSPs, individually.
A total of 1183 PMPs were identified in 1486 eligible patients (mean PMP/colonoscopy
= 0.80; PMP detection rate = 47%). In univariate and multivariate analyses, PMP detection
as well as detection of APs or SSPs individually did not vary significantly in relation
to the hour of the day. In a binary comparison of morning (am) versus afternoon (pm)
procedures, the total polyp detection rate was 67% and 66%, respectively. For PMPs,
APs, SSPs, and hyperplastic polyps (HPs), the am and pm detection rates were 46% and
47%, 41% and 44%, 8% and 8%, and 27% and 24%, respectively. Bowel preparation quality
was independent of time of day and was rated excellent or good in 86% to 87% of cases.
Retrospective, nonrandomized study.
Stable PMP, AP, SSP, and HP detection rates throughout the workday occur under certain
practice conditions, including the use of split-dose bowel preparation and/or moderated
daily colonoscopist procedure loads.
Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby,
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