查看更多>>摘要：AIM:To complete a quality audit using recently published criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable.METHtODS:Consecutive colonoscopy reports of patients at average/high risk screening,or with a prior colorectal neoplasia (CRN) by endoscopists who perform 11 000 procedures yearly,using a commercial computerized endoscopic report generator.A separate institutional database providing pathological results.Required documentation included patient demographics,history,procedure indications,technical descriptions,colonoscopy findings,interventions,unplanned events,follow-up plans,and pathology results.Reports abstraction employed a standardized glossary with 10％ independent data validation.Sample size calculations determined the number of reports needed.RESULTS:Two hundreds and fifty patients (63.2 ±10.5 years,female:42.8％,average risk:38.5％,personal/family history of CRN:43.3％/20.2％) were scoped in June 2009 by 8 gastroenterologists and 3 surgeons (mean practice:17.1 ± 8.5 years).Procedural indication and informed consent were always documented.14％ provided a previous colonoscopy date (past polypremoval information in 25％,but insufficient in most to determine surveillance intervals appropriateness).Most procedural indicators were recorded (exam date:98.4％,medications:99.2％,difficulty level:98.8％,prep quality:99.6％).All reports noted extent of visualization (cecum:94.4％,with landmarks noted in 78.8％-photodocumentation:67.2％).No procedural times were recorded.One hundred and eleven had polyps (44.4％) with anatomic location noted in 99.1％,size in 65.8％,morphology in 62.2％; removal was by cold biopsy in 25.2％ (cold snare:18％,snare cautery:31.5％,unrecorded:20.7％),84.7％ were retrieved.Adenomas were noted in 24.8％(advanced adenomas:7.6％,cancer:0.4％) in this population with varying previous colonic investigations.CONCLUSION:This audit reveals lacking reported items,justifying additional research to optimize quality of reporting.
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