Clin Endosc.  2017 Jul;50(4):322-327. 10.5946/ce.2017.077.

Training in Endoscopy: Colonoscopy

Affiliations
  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym University School of Medicine, Hwaseong, Korea. jhj1229@hallym.or.kr

Abstract

Colonoscopy is effective in reducing the morbidity and mortality associated with colorectal cancer (CRC). Interval cancers or post-colonoscopy CRCs, are cancers detected within the surveillance interval, or between 6-36 months after a clearing colonoscopy. The incidence of interval cancers is 3.4%-9.2% of all detected CRCs, as reported in population-based studies. Colonoscopy is a technically difficult procedure that is challenging to learn, and needs time and effort to gain competency. Therefore, trainee competence is a critical component of CRC screening and surveillance. Herein, we review the colonoscopy training methods and quality assessment metrics for colonoscopy competency.

Keyword

Colonoscopy; Education

MeSH Terms

Colonoscopy*
Colorectal Neoplasms
Education
Endoscopy*
Incidence
Mass Screening
Mental Competency
Mortality

Cited by  1 articles

Current Endoscopy Training in Korea and Future Aspects
Young-Eun Joo
Korean J Gastroenterol. 2022;80(5):207-210.    doi: 10.4166/kjg.2022.122.


Reference

1. Jacob BJ, Moineddin R, Sutradhar R, Baxter NN, Urbach DR. Effect of colonoscopy on colorectal cancer incidence and mortality: an instrumental variable analysis. Gastrointest Endosc. 2012; 76:355–364.e1.
Article
2. Kahi CJ, Imperiale TF, Juliar BE, Rex DK. Effect of screening colonoscopy on colorectal cancer incidence and mortality. Clin Gastroenterol Hepatol. 2009; 7:770–775. quiz 711.
Article
3. Nishihara R, Wu K, Lochhead P, et al. Long-term colorectal-cancer incidence and mortality after lower endoscopy. N Engl J Med. 2013; 369:1095–1105.
Article
4. Kaminski MF, Regula J, Kraszewska E, et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med. 2010; 362:1795–1803.
Article
5. Bressler B, Paszat LF, Chen Z, Rothwell DM, Vinden C, Rabeneck L. Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterology. 2007; 132:96–102.
Article
6. Corley DA, Jensen CD, Marks AR, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014; 370:1298–1306.
Article
7. Korman LY, Overholt BF, Box T, Winker CK. Perforation during colonoscopy in endoscopic ambulatory surgical centers. Gastrointest Endosc. 2003; 58:554–557.
Article
8. Sedlack RE, Kolars JC, Alexander JA. Computer simulation training enhances patient comfort during endoscopy. Clin Gastroenterol Hepatol. 2004; 2:348–352.
Article
9. Haycock A, Koch AD, Familiari P, et al. Training and transfer of colonoscopy skills: a multinational, randomized, blinded, controlled trial of simulator versus bedside training. Gastrointest Endosc. 2010; 71:298–307.
Article
10. Shah SG, Brooker JC, Thapar C, Suzuki N, Williams CB, Saunders BP. Effect of magnetic endoscope imaging on patient tolerance and sedation requirements during colonoscopy: a randomized controlled trial. Gastrointest Endosc. 2002; 55:832–837.
Article
11. Mark-Christensen A, Brandsborg S, Iversen LH. Magnetic endoscopic imaging as an adjuvant to elective colonoscopy: a systematic review and meta-analysis of randomized controlled trials. Endoscopy. 2015; 47:251–261.
Article
12. Hotta K, Katsuki S, Ohata K, et al. A multicenter, prospective trial of total colonoscopy using a short double-balloon endoscope in patients with previous incomplete colonoscopy. Gastrointest Endosc. 2012; 75:813–818.
Article
13. Sunada K, Shinozaki S, Yano T, et al. Double-balloon colonoscopy has a higher cecal intubation rate than conventional colonoscopy using a colon simulator. Dig Dis Sci. 2017; 62:979–983.
Article
14. Baumann UA. Water intubation of the sigmoid colon: water instillation speeds up left-sided colonoscopy. Endoscopy. 1999; 31:314–317.
Article
15. Hafner S, Zolk K, Radaelli F, Otte J, Rabenstein T, Zolk O. Water infusion versus air insufflation for colonoscopy. Cochrane Database Syst Rev. 2015; (5):CD009863.
Article
16. East JE, Suzuki N, Arebi N, Bassett P, Saunders BP. Position changes improve visibility during colonoscope withdrawal: a randomized, blinded, crossover trial. Gastrointest Endosc. 2007; 65:263–269.
Article
17. Ghosh S, Iacucci M. Dynamic position change at colonoscopy improves adenoma detection. Can J Gastroenterol. 2013; 27:508.
Article
18. Lucendo AJ. Colonoscopy in obese patients: time to change position. Dig Dis Sci. 2013; 58:608–609.
Article
19. Ou G, Kim E, Lakzadeh P, et al. A randomized controlled trial assessing the effect of prescribed patient position changes during colonoscope withdrawal on adenoma detection. Gastrointest Endosc. 2014; 80:277–283.
Article
20. Köksal AŞ, Kalkan IH, Torun S, et al. A simple method to improve adenoma detection rate during colonoscopy: altering patient position. Can J Gastroenterol. 2013; 27:509–512.
Article
21. Ball AJ, Johal SS, Riley SA. Position change during colonoscope withdrawal increases polyp and adenoma detection in the right but not in the left side of the colon: results of a randomized controlled trial. Gastrointest Endosc. 2015; 82:488–494.
Article
22. Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy. Am J Gastroenterol. 2015; 110:72–90.
Article
23. Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2015; 81:31–53.
Article
24. Rajasekhar PT, Rutter MD, Bramble MG, et al. Achieving high quality colonoscopy: using graphical representation to measure performance and reset standards. Colorectal Dis. 2012; 14:1538–1545.
Article
25. Lee TJ, Rutter MD, Blanks RG, et al. Colonoscopy quality measures: experience from the NHS Bowel Cancer Screening Programme. Gut. 2012; 61:1050–1057.
Article
26. Shahidi N, Ou G, Telford J, Enns R. Establishing the learning curve for achieving competency in performing colonoscopy: a systematic review. Gastrointest Endosc. 2014; 80:410–416.
27. Hendry PO, Jenkins JT, Diament RH. The impact of poor bowel preparation on colonoscopy: a prospective single centre study of 10,571 colonoscopies. Colorectal Dis. 2007; 9:745–748.
Article
28. Bernstein CN, Greenberg H, Boult I, Chubey S, Leblanc C, Ryner L. A prospective comparison study of MRI versus small bowel follow-through in recurrent Crohn’s disease. Am J Gastroenterol. 2005; 100:2493–2502.
Article
29. Jang JY, Chun HJ. Bowel preparations as quality indicators for colonoscopy. World J Gastroenterol. 2014; 20:2746–2750.
Article
30. Kilgore TW, Abdinoor AA, Szary NM, et al. Bowel preparation with split-dose polyethylene glycol before colonoscopy: a meta-analysis of randomized controlled trials. Gastrointest Endosc. 2011; 73:1240–1245.
Article
31. Eun CS, Han DS, Hyun YS, et al. The timing of bowel preparation is more important than the timing of colonoscopy in determining the quality of bowel cleansing. Dig Dis Sci. 2011; 56:539–544.
Article
32. Hong SN, Sung IK, Kim JH, et al. The effect of the bowel preparation status on the risk of missing polyp and adenoma during screening colonoscopy: a tandem colonoscopic study. Clin Endosc. 2012; 45:404–411.
Article
33. Aronchick CA. Bowel preparation scale. Gastrointest Endosc. 2004; 60:1037–1038. ; author reply 1038-1039.
Article
34. Calderwood AH, Jacobson BC. Comprehensive validation of the Boston bowel preparation scale. Gastrointest Endosc. 2010; 72:686–692.
Article
35. Rostom A, Jolicoeur E. Validation of a new scale for the assessment of bowel preparation quality. Gastrointest Endosc. 2004; 59:482–486.
Article
36. Kahi CJ, Vemulapalli KC, Johnson CS, Rex DK. Improving measurement of the adenoma detection rate and adenoma per colonoscopy quality metric: the Indiana University experience. Gastrointest Endosc. 2014; 79:448–454.
Article
37. Overholt BF, Brooks-Belli L, Grace M, et al. Withdrawal times and associated factors in colonoscopy: a quality assurance multicenter assessment. J Clin Gastroenterol. 2010; 44:e80–e86.
38. Rex DK. Colonoscopic withdrawal technique is associated with adenoma miss rates. Gastrointest Endosc. 2000; 51:33–36.
Article
39. Lee RH, Tang RS, Muthusamy VR, et al. Quality of colonoscopy withdrawal technique and variability in adenoma detection rates (with videos). Gastrointest Endosc. 2011; 74:128–134.
Article
40. Rees CJ, Thomas Gibson S, Rutter MD, et al. UK key performance indicators and quality assurance standards for colonoscopy. Gut. 2016; 65:1923–1929.
Article
41. Lee BI, Hong SP, Kim SE, et al. Korean guidelines for colorectal cancer screening and polyp detection. Clin Endosc. 2012; 45:25–43.
Article
42. Lee BI, Hong SP, Kim SE, et al. [Korean guidelines for colorectal cancer screening and polyp detection]. Korean J Gastroenterol. 2012; 59:65–84.
Article
43. Millan MS, Gross P, Manilich E, Church JM. Adenoma detection rate: the real indicator of quality in colonoscopy. Dis Colon Rectum. 2008; 51:1217–1220.
Article
44. Rex DK, Petrini JL, Baron TH, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2006; 63(4 Suppl):S16–S28.
Article
45. Rex DK, Bond JH, Winawer S, et al. Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2002; 97:1296–1308.
Article
46. van Rijn JC, Reitsma JB, Stoker J, Bossuyt PM, van Deventer SJ, Dekker E. Polyp miss rate determined by tandem colonoscopy: a systematic review. Am J Gastroenterol. 2006; 101:343–350.
Article
47. Coe SG, Crook JE, Diehl NN, Wallace MB. An endoscopic quality improvement program improves detection of colorectal adenomas. Am J Gastroenterol. 2013; 108:219–226. ; quiz 227.
Article
48. Barclay RL, Vicari JJ, Greenlaw RL. Effect of a time-dependent colonoscopic withdrawal protocol on adenoma detection during screening colonoscopy. Clin Gastroenterol Hepatol. 2008; 6:1091–1098.
Article
49. Corley DA, Jensen CD, Marks AR. Can we improve adenoma detection rates? A systematic review of intervention studies. Gastrointest Endosc. 2011; 74:656–665.
Article
50. van Doorn SC, Klanderman RB, Hazewinkel Y, Fockens P, Dekker E. Adenoma detection rate varies greatly during colonoscopy training. Gastrointest Endosc. 2015; 82:122–129.
Article
51. Nelson DB, McQuaid KR, Bond JH, Lieberman DA, Weiss DG, Johnston TK. Procedural success and complications of large-scale screening colonoscopy. Gastrointest Endosc. 2002; 55:307–314.
Article
52. Rutter MD, Nickerson C, Rees CJ, Patnick J, Blanks RG. Risk factors for adverse events related to polypectomy in the English Bowel Cancer Screening Programme. Endoscopy. 2014; 46:90–97.
Article
Full Text Links
  • CE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr