scholarly journals Impact of enhanced personal protective equipment on colonoscopy performance during the COVID-19 pandemic

2020 ◽  
Vol 08 (06) ◽  
pp. E809-E814 ◽  
Author(s):  
Kevin Kim Jun Teh ◽  
Shu Wen Tay ◽  
Kaina Chen ◽  
Samantha Jingyun Koh ◽  
Yu Jun Wong ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Disease Transmission ◽  
Detection Rate ◽  
Protective Equipment ◽  
Procedure Time ◽  
Total Procedure Time ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
The Impact ◽  
Total Procedure

Abstract Background and study aims Using personal protective equipment (PPE) can reduce risk of disease transmission. During the COVID-19 pandemic, enhanced PPE (EPPE) is recommended when performing endoscopy. We aimed to evaluate the impact of EPPE on colonoscopy performance when compared to standard PPE (SPPE). Patients and methods A review of electronic medical records and endoscopy reports of consecutive patients who underwent colonoscopy during two similar one-month time periods (in 2019 and during the COVID-19 pandemic in 2020) was performed. SPPE was used in 2019 and EPPE was used in 2020. Patient clinical data and procedure-related information were captured and analyzed. The primary outcomes were time to cecum (TTC) and total procedure time. Secondary outcomes were adenoma detection rate (ADR), polyp detection rate (PDR) and cecal intubation rate (CIR). Statistical analysis was performed using STATA v16.1. Results Two hundred and forty-seven colonoscopy procedures were analyzed. Baseline demographics and indications for colonoscopy of patients in both groups were similar. There were no significant differences in median TTC (10.0 vs 10.0 min, P = 0.524) or total procedure time (22.5 vs 23.0 min, P = 0.946) between colonoscopy performed in SPPE and EPPE. The ADR, PDR and CIR were also similar. Conclusion Our findings suggest that use of EPPE does not affect colonoscopy performance.

scholarly journals 397 Impact of COVID-19 on Theatre Utility

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
C Luney ◽  
C Little
Keyword(s):  
Elective Surgery ◽  
Time Interval ◽  
Electronic Database ◽  
Procedure Time ◽  
Excessive Heat ◽  
Total Procedure Time ◽  
Significant Difference ◽  
The Impact ◽  
Level 2 ◽  
Total Procedure

Abstract Introduction Covid-19 has significantly impacted the environment in which surgeons operate. Level-2 PPE is worn in our orthopaedic theatres, with increased time taken for simple tasks due to claustrophobia, excessive heat, and difficulties in communication due to masks, including donning and doffing. We sought to determine the impact of Covid-19 on theatre utility. Method 8week period during Covid-19 was reviewed for semi-elective orthopaedic surgery. Pre-Covid-19 case controls for age, procedure and ASA were identified. Electronic database was used to determine total time in theatre complex, time taken for anaesthesia, total procedure time, and time taken for patient to leave the theatre. Results 27patients undergoing semi-elective surgery during Covid-19 pandemic and 27-matched controls from before pandemic were identified. No statistically significant difference in procedural or anaesthetic time. Significant difference in time interval between cases (14minutes pre-Covid-19 v 58minutes during Covid-19; p < 0.05). Mean theatre start times are 51minutes later during Covid-19. Conclusions Procedural times of surgery have not significantly increased, however the time between cases has increased; resulting in a decrease in overall theatre complex utility and direct impact on future costing.

scholarly journals A108 ARE INPATIENTS STILL MORE LIKELY TO FAIL BOWEL PREPARATION IN THE SPLIT-DOSE ERA? FINDINGS FROM 47, 292 COLONOSCOPIES IN THE SOUTHWEST ONTARIO COLONOSCOPY COHORT

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 85-86
Author(s):  
M Sey ◽  
A Wong ◽  
C McDonald ◽  
E Y Liu ◽  
B Yan
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
High Rate ◽  
Ordinal Scale ◽  
Polyp Detection ◽  
Split Dose ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Inadequate Bowel Preparation ◽  
The Impact

Abstract Background Prior studies before the widespread use of split-dose bowel preparation have shown a high rate of inadequate bowel preparation in hospitalized patients. Whether this is still true in the era of split-dose bowel preparation is unknown. Aims To determine the impact of inpatient status on bowel preparation quality in the contemporary era of split-dose bowel preparation. Methods The Southwest Ontario Colonoscopy cohort consists of all inpatient and outpatient colonoscopies performed between April 2017 and Oct 2018 at 21 hospitals serving a large geographic health region. Procedures done in patients < 18 years of age or by an endoscopist performing <50 colonoscopies/year were excluded. Data were collected through a mandatory quality assurance form that was completed by the endoscopist after each procedure. Pathology reports were manually reviewed. The primary outcome was adequate bowel preparation, defined on an ordinal scale as “good” or “fair” rather than “poor”. Secondary outcomes included adenoma detection rate (ADR), sessile serrated polyp detection rate (ssPDR), polyp detection rate (PDR), and cecal intubation rate (CIR). Results A total of 47,292 colonoscopies were performed by 75 physicians (36.2% by gastroenterologists, 60% by general surgeons, 4% others), of which 1,690 were inpatients (3.6%). Inpatients were older (mean 66.8 years vs 60.2 years, p<0.0001), more co-morbid (≥ASA grade 3, 53.6% vs 23.7%, p<0.0001), performed for symptomatic indications (95.7% vs 48.6%, p< 0.0001), have trainee involvement (47% vs 11.6% p<0.001), and less likely to receive split-dose bowel preparation (71.7% vs 91.6% p<0.001). On crude analysis, inpatients were less likely to have adequate bowel preparation (86.2% vs 97.6% p<0.001). On multi-variable analysis, inpatients had lower odds of achieving adequate bowel preparation (OR=0.41, 95% CI 0.33 - 0.50, p<0.001), lower ADR (OR=0.47, 95% CI 0.40 - 0.55, p<0.001), lower PDR (OR=0.54, 95% CI 0.47 - 0.61 p<0.001) and lower CIR (OR = 0.43, 95% CI 0.35 - 0.54, p<0.001). Conclusions In the era of split-dose bowel preparation, inpatient status is still an important predictor of inadequate bowel preparation with resultant lower quality outcome metrics. Funding Agencies None

scholarly journals Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network

2018 ◽  
Vol 11 ◽  
pp. 175628481877505 ◽  
Author(s):  
Guillaume Perrod ◽  
Elia Samaha ◽  
Gabriel Rahmi ◽  
Sherine Khater ◽  
Leila Abbes ◽  
...  
Keyword(s):  
Lynch Syndrome ◽  
Detection Rate ◽  
Screening Program ◽  
Interval Cancer ◽  
Surveillance Program ◽  
Polyp Detection ◽  
Colonoscopic Surveillance ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
The Impact

Background: Despite colonoscopic screening, colorectal cancer (CRC) remains frequent in patients with Lynch syndrome (LS). The objective of this study was to evaluate the impact of an optimized colorectal screening program within a French dedicated network. Methods: All LS patients followed at our institution were consecutively included in the Prédisposition au Cancer Colorectal-Ile de France (PRED-IdF) network. Patients were offered an optimized screening program allowing an adjustment of the interval between colonoscopies, depending on bowel preparation, chromoendoscopy achievement and adenoma detection. Colonoscopies were defined as optimal when all the screening criteria were respected. We compared colonoscopy quality and colonoscopy detection rate before and after PRED-IdF inclusion, including polyp detection rate (PDR), adenoma detection rate (ADR) and cancer detection rate (CDR). Results: Between January 2010 and January 2016, 144 LS patients were consecutively included (male/female = 50/94, mean age = 51 ± 13 years and mutations: MLH1 = 39%, MSH2 = 44%, MSH6 = 15%, PMS2 = 1%). A total of 564 colonoscopies were analyzed, 353 after inclusion and 211 before. After PRED-IdF inclusion, 98/144 (68%) patients had optimal screening colonoscopies versus 33/132 (25%) before ( p < 0.0005). The optimal colonoscopy rate was 304/353 (86%) after inclusion versus 87/211 (41%) before, ( p < 0.0001). PRED-IdF inclusion was associated with a reduction of CRC occurrence with a CDR of 1/353 (0.3%) after inclusion versus 6/211 (2.8%) before ( p = 0.012). ADR and PDR were 99/353 (28%) versus 60/211 (28.8%) ( p > 0.05) and 167/353 (48.1%) versus 90/211 (42.2%) ( p > 0.05), respectively after and before inclusion. Conclusions: An optimized colonoscopic surveillance program in LS patients seems to improve colonoscopic screening quality and might possibly decrease colorectal interval cancer occurrence. Long-term cohort studies are needed to confirm these results.

scholarly journals The Impact of Face Shields on the Quality of Colonoscopy During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Jong Yoon Lee ◽  
Yeo Wool Kang ◽  
Jong Hoon Lee
Keyword(s):  
Quality Indicators ◽  
Detection Rate ◽  
Lesion Detection ◽  
University Hospital ◽  
Detection Rates ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Colonoscopy Quality ◽  
The Impact

Abstract Background: The coronavirus disease 2019 (COVID-19) has become a global pandemic. Healthcare workers are at a higher risk for exposure to COVID-19 infection than the general population. During the COVID-19 pandemic, endoscopists are recommended to wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission. However, to the best of our knowledge, there are no reports on the impact of face shields on the quality of colonoscopy. This study aimed to determine whether the use of PPE, including face shields, affects the quality of colonoscopy during the COVID-19 pandemic.Methods: We retrospectively reviewed the medical records of patients who underwent screening or surveillance colonoscopy performed at Dong-A University Hospital between June 2020 and March 2021 during the COVID-19 pandemic. Endoscopists wore isolation gowns, disposable gloves, and KF94 masks from June 2020 to October 2020. From November 2020, endoscopists additionally wore face shields. Therefore, we compared the colonoscopy quality indicators during the 5 months without the use of face shields and the 5 months with the use of face shields. We calculated the overall adenoma detection rates (ADRs) of the group using face shields and the group not using face shields. Further, the polyp detection rate (PDR), sessile serrated lesion detection rate (SSLDR), advanced neoplasia detection rate (ANDR), polyp per colonoscopy, and adenoma per colonoscopy were calculated for each group.Results: In total, 1,359 patients were included in the study; the face shield and non-face shield groups comprised 679 and 680 patients, respectively. We found no statistically significant differences in the PDR (49.04 vs. 52.50%, p=0.202), ADR (38.59 vs. 38.97%, p=0.884) SSPDR (1.91 vs. 1.32%, p=0.388), and ANDR (3.98 vs. 3.97%, p=0.991) between the groups. In both the experienced endoscopist group and trainee endoscopist group, there was no difference in the colonoscopy quality indicators between the groups of patients examined by endoscopists with and without face shields.Conclusions: The quality indicators of colonoscopy were not affected by face shields during the COVID-19 pandemic.

Nonneoplastic polypectomy during screening colonoscopy: the impact on polyp detection rate, adenoma detection rate, and overall cost

2015 ◽  
Vol 82 (2) ◽  
pp. 370-375.e1 ◽  
Author(s):  
Mary A. Atia ◽  
Neal C. Patel ◽  
Shiva K. Ratuapli ◽  
Erika S. Boroff ◽  
Michael D. Crowell ◽  
...  
Keyword(s):  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Screening Colonoscopy ◽  
Polyp Detection ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
The Impact

scholarly journals Impact of propofol sedation versus opioid/benzodiazepine sedation on colonoscopy outcomes: a systematic review with meta-analysis

2020 ◽  
Vol 08 (06) ◽  
pp. E701-E707
Author(s):  
Muhammad Aziz ◽  
Simcha Weissman ◽  
Rawish Fatima ◽  
Zubair Khan ◽  
Babu P. Mohan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Detection Rate ◽  
Meta Analysis ◽  
Adenoma Detection Rate ◽  
Advanced Adenoma ◽  
Polyp Detection ◽  
Propofol Sedation ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
The Impact

Abstract Background and study aims Choice of sedation (propofol vs opioid/benzodiazepine) has been studied in the literature and has shown variable outcomes. The majority of recent studies have evaluated propofol sedation (PS) versus opioids, benzodiazepines, or a combination of both. We performed a systematic review and meta-analysis of studies comparing PS to other sedation methods to assess the impact on colonoscopy outcomes. Methods Multiple databases were searched and studies of interest were extracted. Primary outcome of the study was adenoma detection rate (ADR) and secondary outcomes included polyp detection rate (PDR), advanced adenoma detection rate (AADR), and cecal intubation rate (CIR). Results A total of 11 studies met the inclusion criteria with a total of 177,016 patients (148,753 and 28,263 in the opioids/benzodiazepine group and PS group, respectively). Overall, ADR (RR: 1.07, 95 % CI 0.99–1.15), PDR (RR: 1.01, 95 % CI 0.93–1.10), and AADR (RR: 1.17, 95 % CI 0.92–1.48) did not improve with the use of PS. The CIR was slightly higher for propofol sedation group (RR 1.02, 95 % CI 1.00–1.03). Conclusion Based on our analysis, PS and opioid/benzodiazepine sedation seem to have comparable ADR. Our results do not favor use of a particular sedation method and the choice of sedation should be individualized based on patient preference, risk factors and resource availability.

Impact of COVID-19 on Nuclear Medicine in Germany, Austria and Switzerland: An International Survey in April 2020

2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann
Keyword(s):  
Nuclear Medicine ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
Large Scale ◽  
Diagnostic Procedures ◽  
Protective Equipment ◽  
Current Crisis ◽  
Web Based ◽  
Public Versus Private ◽  
The Impact

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

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