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• W2080958718 abstract "Introduction and Aim: Documenting colonoscopy completion is an important aspect of quality assurance and a suitable tool is not yet available. The aim of this study was to independently assess the reliability of caecal or terminal ileal photographs as a proof of colonoscopy completion. Materials and Methods: Colonoscopists were requested to take a convincing photograph of the caecum or terminal ileum to document completion of their examination during a prospective colonoscopy audit in a District General Hospital. 177 photographs were collected over 8 months. A further 23 controls (taken of other regions of the large bowel) photographs were added randomly. Based on the landmark captured they were further divided into group “D” when only appendicial orifice was captured, “E” when appendiceal and ileocaecal valve were captured, “F” when only ileocaecal valve was captured, “G” when terminal ileum was captured without water flush and “H” when the terminal ileum was photographed after a water flush. Water flush was used to enhance the villi. Eight independent clinicians (4 colorectal surgeons and 4 gastroenterologists) were requested to categorise the photos as “caecum, terminal ileum or not sure”. Those identified as caecum and terminal ileum were further graded as 1, 2 or 3 depending on the level of certainty. Results: A total of 200 photographs were used. The true locations were caecal in 91 (45.5%) cases, terminal ileal in 86 (43%) cases and 23 (11.5%) were controls. Appendiceal orifice is the most commonly captured landmark (group D, 69 cases -34.5%). Other landmarks captured were group E -13 (6.5%), F - 9 (4.5%), G - 47 (23.5%), and H - 39 (19.5%). Thirty eight percent of the caecal photographs, 71% of the terminal ileal photographs (with and without water flush) and 85.8% of the terminal ileal photographs with water flush technique were identified with a certainty of grade 2 or 3. When all the grades were considered, 93.9% of the terminal ileal photographs with water flush technique were identified. Appendiceal photos obtained the lowest mean grade of 1.2 and terminal ileal photos with water flush obtained the highest grading with a mean score of 2.6. Interestingly 15% of the control photographs were interpreted as caecum and a further 15% as terminal ileum. Conclusion: A photograph of the terminal ileum after flushing with water appears to be a reliable and safe technique for documenting colonoscopy completion. This is less invasive and less costly when compared to terminal ileal biopsy which is currently the gold standard. Caecal photographs do not appear to be a reliable way to document completion due to high inter-observer variability." @default.
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• W2080958718 date "2006-04-01" @default.
• W2080958718 modified "2023-09-26" @default.
• W2080958718 title "Is a Photograph of the Caecum Or Terminal Ileum Reliable Enough for Documenting Completion of Colonoscopy - A Prospective Study?" @default.
• W2080958718 doi "https://doi.org/10.1016/j.gie.2006.03.135" @default.
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