Performance Measures of Surgeon-endoscopists in a Veterans Affairs Medical Center: Appropriateness of Surgical Resident Colonoscopy Training

Objective: Colonoscopy training is recognized to be important for surgical resident training. This study aimed to determine if surgeon-endoscopists meet quality indicators in the performance of colonoscopy in a Veteran’s Medical Center.
Methods: Retrospective review of prospective standardized computer endoscopic reporting database (ProVationMDR). All colonoscopies performed by two attending surgeons (one general and one colorectal) between January 1, 2004 and July 31, 2007 were included in the study. Exclusion criteria included flexible sigmoidoscopies and incomplete reporting. Quality indicators used included the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) criteria for colorectal cancer screening and the American Society for Gastrointestinal Endoscopy (ASGE) quality indicators for colonoscopy.
Results: 568 patients’ data were analyzed. Average patient’s age was 63 y/o (range 27-89 y/o); 96% were male. Ninety-seven percent of colonoscopies were performed in accordance to established criteria. The most common indications for colonoscopy were: surveillance 205 (36%) for either a history of polyps in 87 (15%), or postsurgical 118 (21%); screening 157 (28%); rectal bleeding 18%; pain 19 (4%); anemia 15 (3%). Postcancer resection surveillance colonoscopies were performed within recommended guidelines criteria in 98% of the cases. Cecal intubation rate was 97% (versus ASGE quality target of 95%). Adenoma detection rate (ADR) was 25% overall (versus ASGE ADR of equal or greater than 25% among men, and 15% among women over the age of 50). Complications requiring intervention occurred in 2 patients (

Session: Podium Presentation

Program Number: S066

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