Aims and Objectives:
Assess the success rate of all colonoscopies carried out in University Hospitals of Leicester (UHL) NHS Trust between September 2011 and 2012. This will then be compared with the results of audits in 2006–2007, 2007–2008, and 2010–2011.
Assess the complication rate and reasons for failure of colonoscopies carried out during the audit period.
Enable improvement in practise by highlighting poor practise and encouraging reflection.
Caecal Intubation: > 90%.
Perforation rate: < 1:1000 colonoscopies.
Methods A retrospective search was made of the colonoscopy database of all colonoscopies performed on patients above the age of eighteen in UHL between September 2011 and September 2012. In addition a comparison was made between the colonoscopy database and patients presenting to UHL hospitals with a diagnosis of perforation. This was to identify late presentation of perforations potentially due to colonoscopies. The procedural notes were analysed looking for: Successful visualisation of the Caecum, Ileum/neo TI or anastomosis; reasons for failure, if applicable and complications. The results were then pooled and compared against the audit standard.
Results 4001 colonoscopies were performed over the audit period. 3680 (92%) were successful. There were 80 complications (2%) in total. Most common complications were difficult intubation and patient distress with 52 (1.3%) and 16 (0.4%) instances respectively. 1 (0.02%) perforation occurred. Success rate over 5 years: 69% in 2006–2007, 89% in 2007–2008, 93% in 2010–2011 and 92% in 2011–2012.
Conclusion Over the audit period UHL achieved its colonoscopy targets with a success rate of 92% and a perforation rate of 1 in 4001. Over the past five years the colonoscopy success rate has steadily improved from 69% in 2006–2007 to 92% in 2011–2012. Over the past two years UHL has achieved its target with success rates of 93% and 92% respectively. The results of each audit are reviewed by the endoscopy lead who meets people who have completion rates below the national average and also those who are doing less than a hundred and fifty colonoscopies a year. The aim of the meeting is to inform them of their performance and offer opportunities for improvement e.g. training. This shows the value of these audits in highlighting poor practise and prompting reflection and improvement.
Disclosure of Interest None Declared
Gut. 2012 Jul; 61(7):1050–7. Epub 2011 Sep 22
Gastroenterology Volume 143, Issue 3, Pages 844–857, September 2012