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Colonoscopy: Art or science?

Abstract：

:The focus on colorectal neoplasia has led to an exponential increase in the use of colonoscopy in many countries. Although colonoscopy facilitates the diagnosis and treatment of colonic disease, there are public health issues that include access, training, diagnostic accuracy, complications and additions to health-care costs. Because of this, colonoscopists have a responsibility to ensure that the procedure is appropriate, safe and of high-quality. This article addresses the issue of variation in technical skills that is known to exist within the endoscopic community, even among individuals with similar experience. While some of this variation reflects innate manual dexterity, another aspect is variation in the adoption of technical manoeuvers that facilitate various aspects of the procedure including rates for cecal intubation. Although technical manoeuvers are difficult to evaluate in controlled trials, there is persuasive data that high cecal intubation rates can be achieved by minimizing inflation and looping in the sigmoid colon and by the appropriate use of positional changes and abdominal pressure. In difficult settings, there is also benefit from the use of non-standard endoscopes and various accessories including overtubes.

journal_name

J Gastroenterol Hepatol

journal_title

Journal of gastroenterology and hepatology

authors

Roberts-Thomson IC,Teo E

doi

10.1111/j.1440-1746.2008.05739.x

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

180-4

issue

2

eissn

0815-9319

issn

1440-1746

pii

JGH5739

journal_volume

24

pub_type

杂志文章,评审

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