Original article
Clinical endoscopy
The impact of video recording colonoscopy on adenoma detection rates

https://doi.org/10.1016/j.gie.2011.07.048Get rights and content

Background

The adenoma detection rate (ADR) is a quality benchmark for colonoscopy, influenced by several factors including bowel preparation, withdrawal time, and withdrawal technique.

Objective

To assess the impact of video recording of all colonoscopies on the ADR.

Design

Comparison of two cohorts of patients undergoing colonoscopy before and after implementation of video recording.

Setting

Academic outpatient endoscopy facility.

Patients

This study involved asymptomatic, average-risk adults undergoing screening colonoscopy.

Intervention

Video recording of all colonoscopy procedures. Polyp findings and withdrawal times were recorded for 208 consecutive screening colonoscopies. A policy of video recording all colonoscopies was implemented and announced to the staff. Data on another 213 screening colonoscopies were subsequently collected.

Main Outcome Measurements

Adenoma detection rate, withdrawal time, advanced polyp detection rate, hyperplastic polyp detection rate.

Results

At least one adenoma was found in 38.5% of patients after video recording versus 33.7% before video recording (P = .31). There was a significant increase in the hyperplastic polyp detection rate (44.1% vs 34.6%; P = .046). Most endoscopists had a numerical increase in their ADRs, but only one was significant (57.7% vs 22.6%; P < .01). There were trends toward higher detection of adenomas of <5 mm (59.1% vs 52%; P = .23) and right-sided adenomas (40.2% vs 30.4%; P = .11) in the video recorded group.

Limitations

No randomization, confounding of intervention effects, and sample size limitations.

Conclusion

Video recording of colonoscopies is associated with a nonsignificant increase in the ADR and a significant increase in the hyperplastic polyp detection rate. There may be a benefit of video recording for endoscopists with low ADRs.

Section snippets

Research design and methods

The study was approved by the University of Oklahoma Health Sciences Center Institutional Review Board. The study was performed at our outpatient endoscopy facility. All asymptomatic outpatients referred for average-risk screening colonoscopy between the ages of 50 and 80 years who had excellent, good, or fair bowel preparation were included. Procedures with poor bowel preparation requiring a repeat procedure were excluded. Patients with a family history of colorectal cancer in a first-degree

Results

A total of 421 colonoscopies were included, 208 before video recording and 213 after video recording. The patient demographics and characteristics are shown in Table 1. There were no significant differences in patient age or sex. All procedures were performed on outpatient, asymptomatic patients with the indication of colorectal cancer screening.

At least 1 adenoma was found in 38.5% of patients after video recording compared with 33.7% of patients before video recording (P = .31). There was no

Discussion

In this study, we report, for the first time, the effect of video recording of colonoscopies on the ADR among asymptomatic outpatients undergoing colorectal cancer screening. In our study, the ADR was found to be 38.5% after video recording compared with 33.7% before video recording, a difference that failed to reach statistical significance. There were trends toward detecting two or more adenomas, small adenomas, and right-sided adenomas, but these outcomes also failed to reach statistical

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    DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.

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    Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.