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News

Sedation does not increase detection rates in screening colonoscopy

December's issue of the American Journal of Gastroenterology investigates the impact of sedation in screening colonoscopy on quality indicators and complications.

News image

Quality indicators including cecal intubation rate and adenoma detection rate  are established.

Sex differences of quality indicators are observed, but the influence of sedation has not been investigated so far.

Dr Christina Bannert and colleagues assessed the impact of sedation on quality indicators, including cecal intubation rate and adenoma detection rate, according to sex.
 
The research team analyzed data of 52,506 screening colonoscopies performed by 196 endoscopists between 2007 and 2011 according to the Austrian 'quality management for colon cancer prevention' program.
 
Sedation did not affect polyp detection rate or adenoma detection rate for both sexes.

The researchers noted that adenoma detection rate was not significantly influenced by sedation, but by age and sex, when the executing endoscopist was considered.

Sedation improved the cecal intubation rate in women by about 3%
American Journal of Gastroenterology & Hepatology

Although women were more often sedated than men, cecal intubation rate was slightly lower in women than in men.

The team found that sedation improved the cecal intubation rate in women by about 3% , whereas in men it was just over 1%.

With the outcomes of the study it was noted that sedated women only reached the cecal intubation rate of unsedated men.

Accounting for the intra-observer influence of the endoscopist, the overall cecal intubation rate was influenced by the interaction of sex and age, but not by sedation.

Dr Bannert's team concluded "Sedation does not increase adenoma or polyp detection, although it leads to an increase in cecal intubation rate in men and women."

"This effect is more pronounced in women, yet cecal intubation rate of men remains higher compared with women."

"Quality indicators are mainly influenced by the patient's age, sex, and the endoscopists’ individual performance, rather than the endoscopists’ subspeciality or procedural experience."

Am J Gastroenterol 2012; 107:1837–1848
24 December 2012

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