Large bowel standards: quality, polyps, inflammatory bowel disease, stenoses, conventional chromoendoscopy

摘要

The issue of colonoscopy performance is currently of great concern for all important endoscopic societies and researchers. It is clear that the standard endoscopic examination of the large bowel should be of the highest possible quality. However, in recent years it has become clear that colonoscopy is often performed with suboptimal quality in clinical practice. Currently the process of defining quality requirements and quality parameters that should be monitored is underway. The five most important and most easily available quality parameters are: near-perfect bowel preparation, painless colonoscope insertion, high caecal intubation rate, perfect withdrawal technique allowing visualization of nearly all the surface of the bowel, and high adenoma detection rate. A full list of quality parameters and requirements is available elsewhere1. Endoscopic centres are currently supposed to monitor quality of the centre and quality of employed endoscopists. Special Quality Assurance Programmes should be introduced in all centres. In the simplest version quality can be provided if enough time is provided for each procedure, and if adenoma detection rate and caecal intubation rate are monitored.