OBJECTIVE:
Endoscopic examinations are done for several purpose like to diagnose, treat and follow. Nowadays, lower GIS endoscopy is the common method which is used for diagnose and treatment. The differences of upper GIS endoscopy are that the preperation to procedure was more difficult and sometimes repeated procedures were needed because of insufficient bowel cleaning. In this article, we studied failure causes and what we can do about decreasing this failure rate in lower GIS examinations in our endoscopy unit.
METHODS:
13595 lower gastrointestinal endoscopy studies performed between January 2003 and 2010 at the Endoscopy Unit of Vakif Gureba Training and Research Hospital were retrospectively reviewed. Demographic datas, procedures performed and the histopathologic results obtained were recorded. In our study, patients whose bowel cleansing was performed using oral sodium phosphate and BT enema before 2008 were classified as Group 1, and patients whose bowel cleansing was performed using polyethyleneglycol after January 2008 were classified as Group 2. These two groups were compared in terms of bowel cleansing performance.
RESULTS:
In 1177 patients among 9176 in Group 1, the procedure was unsuccessful. 1024 of those procedures failed because of ineffective cleansing. Statistically, no significant difference was found between the groups and years in terms of total failure rate (p: 0,251), however, failure as a result if ineffective bowel preparation was found significantly higher (p: 0,001).
CONCLUSION:
Although a rise in the success rate of lower GIS endoscopy with the alteration of bowel preparation could not be achieved, success rate of bowel preparation has increased. Though the success rate of our endoscopy series is compatible with the various series reported (95% for screening), the main result of the unsuccessful procedures is still ineffective bowel cleansing. The physiologic and socio-cultural characteristics of the patient and appropriate application of the bowel preparation are the other important factors.
Keywords: Lower Gastrointestinal Endoscopy, Bowel Cleansing, Sodium Phosphate, Polyethyleneglycol