S216 Automated Cecal Intubation Rate and Withdrawal Time With Artificial Intelligence. A Video Validation Study

Background and Aims: Coronavirus Disease 2019 (COVID-19) has affected many facets of the practice of medicine including screening colonoscopies. Our study looks to observe if there has been an effect on the quality of colonoscopies, as indicated by quality measures such as cecal intubation rate (CIR), cecal intubation time (CIT), scope withdrawal time (SWT) and adenoma detection rate (ADR) with the adoption of standard COVID-19 precautions. Methods: We conducted a retrospective chart review to analyze the effects of the COVID-19 pandemic on screening colonoscopies. The study utilized data on CIR, CIT, SWT and ADR from outpatient, non-emergent procedures conducted at 3 endoscopy suites of St Lukes University Health Network. All inpatient and emergent procedures were excluded. Data was obtained by performing chart review on EPIC electronic health record. Results: Our study demonstrated that the total number of screening colonoscopies was decreased between 2019 to 2020 (318 in 2019 vs 157 in 2020, p= 0.005). CIT (320+/-105 seconds in 2019 vs 392+/-107 seconds in 2020, p=0.001) and SWT (706+/-232 seconds in 2019 vs 830+/-241 seconds in 2020, p=0.001) were increased while CIR (98.2% in 2019 vs 96.6% in 2020, p=0.04) was decreased between 2019 and 2020 likely due to PPE introduction. ADR was similar between the two groups (38.23 (12.50-66.66) in 2019 vs 38.18(16.66-66.00) in 2020, p=0.8). Conclusion: Our study showed that quality indices for screening colonoscopies like cecal intubation rate, cecal intubation time and scope withdrawal time were negatively impacted during the initial COVID time period compared to pre-COVID time. The study also displayed that though there was a significant decline in both screening and diagnostic colonoscopies during pandemic, adenoma detection rates were comparable. Thus, the efficiency of the procedures was affected by the use of PPE but it did not affect the colonoscopies clinical benefits.

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Efficacy of Endocuff-assisted colonoscopy in the detection of colorectal polyps

Endoscopy International Open ◽

10.1055/s-0044-101142 ◽

2018 ◽

Vol 06 (04) ◽

pp. E425-E431 ◽

Cited By ~ 13

Author(s):

Yoshiki Wada ◽

Masayoshi Fukuda ◽

Kazuo Ohtsuka ◽

Mamoru Watanabe ◽

Yumiko Fukuma ◽

...

Keyword(s):

Detection Rate ◽

Colorectal Polyps ◽

Colorectal Adenomas ◽

Insertion Time ◽

Intubation Rate ◽

Cecal Intubation ◽

Withdrawal Time ◽

Significant Difference ◽

Cecal Intubation Rate ◽

The Mean

Abstract Background and study aims Colonoscopy is the gold standard for detecting colorectal adenomas and cancers. Endoscopic surveillance has been shown to be effective for preventing colorectal cancer. Although detection of colorectal polyps at an early stage is important, endoscopic visualization of early neoplasia can be difficult. The Endocuff is a new device that can be attached to the tip of the colonoscope to hold the colonic folds away from the field of view during withdrawal. The aim of this study was to compare the adenoma detection rate (ADR) and the mean number of adenomas detected per patient (MAP) achieved using Endocuff-assisted colonoscopy (EAC) and standard colonoscopy (SC). Patients and methods This randomized prospective study was conducted at two academic endoscopy departments in Japan. A total of 447 patients underwent a complete colonoscopic examination between April 2015 and September 2015. The EAC group included 239 patients. The cecal intubation rate, insertion time, withdrawal time, pain score, complications, polyp detection rate (PDR), ADR, the mean number of polyps detected per patient (MPP), and the MAP were assessed. Results There were no differences between the EAC and SC groups in terms of cecal intubation rate, insertion time, withdrawal time, or pain scores. The PDR in patients increased by about 12 % (61.9 % vs. 49.2 %, P = 0.013) and ADR increased by 15 % (52.5 % vs. 39.2 %, P = 0.001) with the use of the Endocuff. The advanced ADR was higher in the EAC group but no statistically significant difference was found (7.7 % vs. 4.6 %, P = 0.17). Both MPP and MAP were also higher in the EAC group (mean ± SD: 1.33 ± 1.43 vs. 0.83 ± 0.99 per patient; P < 0.01, 1.11 ± 1.41 vs. 0.66 ± 0.99 per patient; P < 0.01, respectively). No major complications occurred. Conclusions EAC not only enabled a higher ADR but also significantly increased the mean number of adenomas identified per patient, as compared with SC.

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INFLUENCE FACTORS ON CECAL INTUBATION RATE AS A QUALITY AND PERFORMANCE MEASUREMENT IN COLONOSCOPY

10.1055/s-0039-1681770 ◽

2019 ◽

Author(s):

R Mateescu ◽

F Ionita Radu ◽

M Jinga ◽

P Nuta ◽

R Costache ◽

...

Keyword(s):

Performance Measurement ◽

Influence Factors ◽

Intubation Rate ◽

Cecal Intubation ◽

Cecal Intubation Rate ◽

And Performance

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A117 PROPOFOL SEDATION DOES NOT IMPROVE MEASURES OF COLONOSCOPY QUALITY – FINDINGS FROM THE SOUTHWEST ONTARIO COLONOSCOPY COHORT

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.115 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 97-98

Author(s):

M Sey ◽

B Yan ◽

Z Hindi ◽

M Brahmania ◽

J C Gregor ◽

...

Keyword(s):

Detection Rate ◽

Conscious Sedation ◽

Intubation Rate ◽

Polyp Detection ◽

Cecal Intubation ◽

Propofol Sedation ◽

Serrated Polyp ◽

Polyp Detection Rate ◽

Cecal Intubation Rate ◽

Colonoscopy Quality

Abstract Background The use of propofol during colonoscopy has gained increased popularity due to deeper anesthesia compared to conscious sedation. Prior studies examining the use of propofol sedation during colonoscopy have primarily focused on anesthesia outcomes. Whether propofol sedation is associated with improvements in colonoscopy outcomes is uncertain. Aims The primary outcome was adenoma detection rate (ADR). Secondary outcomes were the detection of any adenoma (conventional adenoma, sessile serrated polyp, and traditional serrated adenoma), sessile serrated polyp detection rate, polyp detection rate, cecal intubation rate, and perforation rate. Methods The Southwest Ontario Colonoscopy cohort consists of all patients who underwent colonoscopy between April 2017 and Oct 2018 at 21 hospitals serving a large geographic area in Southwest Ontario. Procedures performed in patients less than 18 years of age or by endoscopist who perform <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. Results A total of 46,634 colonoscopies were performed by 75 physicians (37.5% by gastroenterologists, 60% by general surgeons, 2.5% others) of which 16,408 (35.2%) received propofol and 30,226 (64.8%) received conscious sedation (e.g. combination of a benzodiazepine and a narcotic). Patients who received propofol were likely to have a screening indication (49.2% vs 45.5%, p<0.0001), not have a trainee endoscopist present and be performed at a non-academic centre (32.2% vs 44.6%, p<0.0001). Compared to conscious sedation, use of propofol was associated with a lower ADR (24.6% vs. 27.0%, p<0.0001) and detection of any adenoma (27.7% vs. 29.8%, p<0.0001); no difference was observed in the detection ofsessile serrated polyps (5.0% vs. 4.7%, p=0.26), polyp detection rate (41.2% vs 41.2%, p=0.978), cecal intubation rate (97.1% vs. 96.8%, p=0.15) or perforation rate (0.04% vs. 0.06%,p=0.45). On multi-variable analysis, the use of propofol was not significantly associated with any improvement in ADR (RR=0.90, 95% CI 0.74–1.10, p=0.30), detection of any adenoma (RR=0.93, 95% CI 0.75–1.14, p=0.47), sessile serrated polyp detection rate (RR=1.20, 95%CI 0.90–1.60, p=0.22), polyp detection rate (RR=1.00, 95% CI 0.90–1.11, p=0.99), or cecal intubation rate (RR=1.00, 95%CI 0.80–1.26, p=0.99). Conclusions The use of propofol sedation does not improve colonoscopy quality metrics. Funding Agencies None

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153 The Twelve-Hour Battery Given Wireless PillCam Sb2ex Improves Overall Cecal Intubation Rate and Increases the Positive Yield

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2012.04.024 ◽

2012 ◽

Vol 75 (4) ◽

pp. AB125-AB126 ◽

Cited By ~ 1

Author(s):

Neel K. Mann ◽

Navin Paul ◽

Simon K. Lo

Keyword(s):

Intubation Rate ◽

Cecal Intubation ◽

Cecal Intubation Rate

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Diagnostic application of water exchange colonoscopy: A meta-analysis of randomized controlled trials

Journal of International Medical Research ◽

10.1177/0300060518819626 ◽

2019 ◽

Vol 47 (2) ◽

pp. 515-527

Author(s):

Xiufang Xu ◽

Dongqiong Ni ◽

Yuping Lu ◽

Xuan Huang

Keyword(s):

Patient Satisfaction ◽

Detection Rate ◽

Water Exchange ◽

Meta Analysis ◽

Controlled Trials ◽

Intubation Rate ◽

Cecal Intubation ◽

Randomized Controlled ◽

Adenoma Detection ◽

Cecal Intubation Rate

Background Few well-designed studies have investigated water exchange colonoscopy (WE). We performed a meta-analysis to comprehensively evaluate the clinical utility of WE based on high-quality randomized controlled trials (RCTs) and to compare the impacts of WE, water immersion colonoscopy (WI), and gas-insufflation colonoscopy. Methods We searched the Cochrane Library, MEDLINE, Embase, PubMed, Elsevier, CNKI, VIP, and Wan Fang Data for RCTs on WE. We analyzed the results using fixed- or random-effect models according to the presence of heterogeneity. Publication bias was assessed by funnel plots. Results Thirteen studies were eligible for this meta-analysis. The colonoscopic techniques included WE as the study group, and WI and air- or CO2-insufflation colonoscopy as control groups. WE was significantly superior to the control procedures in terms of adenoma detection rate, proportion of painless unsedated colonoscopy procedures, and cecal intubation rate according to odds ratios. WE was also significantly better in terms of maximal pain score and patient satisfaction score according to mean difference. Conclusions WE can remarkably improve the adenoma detection rate, proportion of painless unsedated colonoscopy procedures, patient satisfaction, and cecal intubation rate, as well as reducing the maximal pain score in patients undergoing colonoscopy.

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Tu1932 AUTOMATED INSERTION TIME, CECAL INTUBATION, AND WITHDRAWAL TIME DURING LIVE COLONOSCOPY USING CONVOLUTIONAL NEURAL NETWORKS - A VIDEO VALIDATION STUDY

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2019.03.1076 ◽

2019 ◽

Vol 89 (6) ◽

pp. AB619 ◽

Cited By ~ 6

Author(s):

Christopher Rombaoa ◽

Ankush Kalra ◽

Tyler Dao ◽

James Requa ◽

Andrew Ninh ◽

...

Keyword(s):

Neural Networks ◽

Convolutional Neural Networks ◽

Validation Study ◽

Insertion Time ◽

Cecal Intubation ◽

Withdrawal Time

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Tu1042 Cecal Intubation Rate Correlates With Adenoma Detection Rate But Has No Impact on Advanced Adenoma Detection Rate

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2016.03.1102 ◽

2016 ◽

Vol 83 (5) ◽

pp. AB541

Author(s):

Daniela Sallinger ◽

Elisabeth Waldmann ◽

Monika Ferlitsch ◽

Michael H. Trauner ◽

Martha Britto-Arias ◽

...

Keyword(s):

Detection Rate ◽

Adenoma Detection Rate ◽

Advanced Adenoma ◽

Intubation Rate ◽

Cecal Intubation ◽

Adenoma Detection ◽

Cecal Intubation Rate

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Effect of Hysterectomy on Colonoscopy Completion Rate

Canadian Journal of Gastroenterology ◽

10.1155/2010/319623 ◽

2010 ◽

Vol 24 (6) ◽

pp. 365-368 ◽

Cited By ~ 5

Author(s):

Mélanie Lacasse ◽

Geneviève Dufresne ◽

Emilie Jolicoeur ◽

Luc Rochon ◽

Charles Sabbagh ◽

...

Keyword(s):

Pain Perception ◽

Intubation Rate ◽

Review Of The Literature ◽

Control Groups ◽

Cecal Intubation ◽

Significant Difference ◽

Detectable Difference ◽

Procedural Complication ◽

Cecal Intubation Rate ◽

And Control

BACKGROUND: Several studies show that colonoscopies are technically more difficult to perform in women than men, especially in women who have undergone abdominal and gynecological surgeries. A review of the literature indicates an increased rate of noncompletion of colonoscopies in most cases; however, no studies have investigated the procedural complication rate, sedation requirements and perception of pain in colonoscopies.OBJECTIVE: To determine whether women who have undergone a previous hysterectomy have a higher noncompletion rate when undergoing a colonoscopy, and to assess whether there is a higher percentage of complications. Furthermore, the present study also aimed to ascertain whether these women required more sedation and whether their perception of pain is greater than that of women who did not undergo previous abdominal surgeries.METHODS: The present study was a prospective cohort study of women, 45 to 80 years of age, who underwent colonoscopy (n=508). A total of 229 patients were eligible for the study; they completed a questionnaire, and were subsequently divided into control and hysterectomy groups. Gastroenterologists performed all procedures. After colonoscopy, the patient and endoscopist completed a pain perception questionnaire. Cecal intubation rates were also recorded.RESULTS: No significant difference for cecal intubation rates were detected between the two groups (95.7% and 98.7% in hysterectomy and control groups, respectively; P=0.176). The crude OR for the success rate was 0.29 (95% CI 0.05 to 1.90). There was no significant difference between groups regarding sedation or the type of colonoscope. No correlation between the gastroenterologists’ evaluation of pain and patients’ pain was observed.CONCLUSION: Hysterectomy did not significantly diminish the cecal intubation rate, and there was no detectable difference in pain perception or sedative dose. Colonoscopy remains an excellent screening and diagnostic tool for all women.

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