Endoscopy 2012; 44(4): 444-451
DOI: 10.1055/s-0032-1306690
SEED Guidelines

© Georg Thieme Verlag KG Stuttgart · New York

Clinical practice Guidelines: quality of colonoscopy in colorectal cancer screening

On behalf of the SPANISH SOCIETY OF GASTROINTESTINAL ENDOSCOPY and the SPANISH ASSOCIATION OF GASTROENTEROLOGY.R.  Jover1 , M.  Herráiz1 , O.  Alarcón1 , E.  Brullet1 , L.  Bujanda1 , M.  Bustamante1 , R.  Campo1 , R.  Carreño1 , A.  Castells1 , J.  Cubiella1 , P.  García-Iglesias1 , A.  J.  Hervás1 , P.  Menchén1 , A.  Ono1 , A.  Panadés1 , A.  Parra-Blanco1 , M.  Pellisé1 , M.  Ponce1 , E.  Quintero1 , J.  M.  Reñé1 , A.  Sánchez del Río1 , A.  Seoane1 , A.  Serradesanferm1 , A.  Soriano Izquierdo1 , E.  Vázquez Sequeiros1
  • 1Spanish Society of Gastroenterology (AEG) and Spanish Society of Gastrointestinal Endoscopy (SEED) Working Group.
Weitere Informationen


21. März 2012 (online)

Goals of this clinical practice guidline:

Collecting the evidence about the quality of colonoscopy screening for colorectal cancer (CRC) in order to serve as a tool for screening programs, endoscopy units and endoscopists that perform screening colonoscopies. Defining and establishing quality indicators and minimum requirements based on available evidence that endoscopy units and endoscopists involved in CRC screening programs should meet. Providing evidence about procedures that may improve the quality of colonoscopy.


  • 1 Paterson W G, Depew W T, Pare P et al. Canadian consensus on medically acceptable wait times for digestive health care.  Can J Gastroenterol. 2006;  20(6) 411-423
  • 2 Hui A J, Wong R M, Ching J Y et al. Risk of colonoscopic polypectomy bleeding with anticoagulants and antiplatelet agents: analysis of 1657 cases.  Gastrointest Endosc. 2004;  59(1) 44-48
  • 3 Shiffman M L, Farrel M T, Yee Y S. Risk of bleeding after endoscopic biopsy or polypectomy in patients taking aspirin or other NSAIDS.  Gastrointest Endosc. 1994;  40(4) 458-462
  • 4 Yousfi M, Gostout C J, Baron T H et al. Postpolypectomy lower gastrointestinal bleeding: potential role of aspirin.  Am J Gastroenterol. 2004;  99(9) 1785-1789
  • 5 Friedland S, Soetikno R. Colonoscopy with polypectomy in anticoagulated patients.  Gastrointest Endosc. 2006;  64(1) 98-100
  • 6 Singh M, Mehta N, Murthy U K et al. Postpolypectomy bleeding in patients undergoing colonoscopy on uninterrupted clopidogrel therapy.  Gastrointest Endosc. 2010;  71(6) 998-1005
  • 7 Kim H S, Kim T I, Kim W H et al. Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study.  Am J Gastroenterol. 2006;  101(6) 1333-1341
  • 8 Sawhney M S, Salfiti N, Nelson D B et al. Risk factors for severe delayed postpolypectomy bleeding.  Endoscopy. 2008;  40(2) 115-119
  • 9 Belsey J, Epstein O, Heresbach D. Systematic review: oral bowel preparation for colonoscopy.  Aliment Pharmacol Ther. 2007;  25(4) 373-384
  • 10 Froehlich F, Wietlisbach V, Gonvers J J et al. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study.  Gastrointest Endosc. 2005;  61(3) 378-384
  • 11 Harewood G C, Sharma V K, de Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia.  Gastrointest Endosc. 2003;  58(1) 76-79
  • 12 Rex D K, Imperiale T F, Latinovich D R, Bratcher L L. Impact of bowel preparation on efficiency and cost of colonoscopy.  Am J Gastroenterol. 2002;  97(7) 1696-1700
  • 13 Adler M, Quenon M, Even-Adin D et al. Whole gut lavage for colonoscopy--a comparison between two solutions.  Gastrointest Endosc. 1984;  30(2) 65-67
  • 14 DiPalma J A, Brady C E, III , Stewart D L et al. Comparison of colon cleansing methods in preparation for colonoscopy.  Gastroenterology. 1984;  86(5 Pt 1) 856-860
  • 15 Ell C, Fischbach W, Bronisch H J et al. Randomized trial of low-volume PEG solution versus standard PEG + electrolytes for bowel cleansing before colonoscopy.  Am J Gastroenterol. 2008;  103(4) 883-893
  • 16 Marschall H U, Bartels F. Life-threatening complications of nasogastric administration of polyethylene glycol-electrolyte solutions (Golytely) for bowel cleansing.  Gastrointest Endosc. 1998;  47(5) 408-410
  • 17 Love J, Bernard E J, Cockeram A et al. A multicentre, observational study of sodium picosulfate and magnesium citrate as a precolonoscopy bowel preparation.  Can J Gastroenterol. 2009;  23(10) 706-710
  • 18 Aoun E, Abdul-Baki H, Azar C et al. A randomized single-blind trial of split-dose PEG-electrolyte solution without dietary restriction compared with whole dose PEG-electrolyte solution with dietary restriction for colonoscopy preparation.  Gastrointest Endosc. 2005;  62(2) 213-218
  • 19 Parra-Blanco A, Nicolas-Perez D, Gimeno-Garcia A et al. The timing of bowel preparation before colonoscopy determines the quality of cleansing, and is a significant factor contributing to the detection of flat lesions: a randomized study.  World J Gastroenterol. 2006;  12(38) 6161-6166
  • 20 Rostom A, Jolicoeur E, Dube C et al. A randomized prospective trial comparing different regimens of oral sodium phosphate and polyethylene glycol-based lavage solution in the preparation of patients for colonoscopy.  Gastrointest Endosc. 2006;  64(4) 544-552
  • 21 Sabri M, di Lorenzo C, Henderson W et al. Colon cleansing with oral sodium phosphate in adolescents: dose, efficacy, acceptability, and safety.  Am J Gastroenterol. 2008;  103(6) 1533-1539
  • 22 Church J M. Effectiveness of polyethylene glycol antegrade gut lavage bowel preparation for colonoscopy--timing is the key!.  Dis Colon Rectum. 1998;  41(10) 1223-1225
  • 23 Poon C M, Lee D W, Mak S K et al. Two liters of polyethylene glycol-electrolyte lavage solution versus sodium phosphate as bowel cleansing regimen for colonoscopy: a prospective randomized controlled trial.  Endoscopy. 2002;  34(7) 560-563
  • 24 Aronchick C A. Bowel preparation scale.  Gastrointest Endosc. 2004;  60(6) 1037-1038
  • 25 Lai E J, Calderwood A H, Doros G et al. The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research.  Gastrointest Endosc. 2009;  69(3 Pt 2) 620-625
  • 26 Rostom A, Jolicoeur E. Validation of a new scale for the assessment of bowel preparation quality.  Gastrointest Endosc. 2004;  59(4) 482-486
  • 27 Bretagne J F, Ponchon T. Do we need to embrace adenoma detection rate as the main quality control parameter during colonoscopy?.  Endoscopy. 2008;  40(6) 523-528
  • 28 Pinsky P F, Schoen R E, Weissfeld J L et al. Variability in flexible sigmoidoscopy performance among examiners in a screening trial.  Clin Gastroenterol Hepatol. 2005;  3(8) 792-797
  • 29 Rex D K. Maximizing detection of adenomas and cancers during colonoscopy.  Am J Gastroenterol. 2006;  101(12) 2866-2877
  • 30 Kaminski M F, Regula J, Kraszewska E et al. Quality indicators for colonoscopy and the risk of interval cancer.  N Engl J Med. 2010;  362(19) 1795-1803
  • 31 Faivre J, Dancourt V, Lejeune C et al. Reduction in colorectal cancer mortality by fecal occult blood screening in a French controlled study.  Gastroenterology. 2004;  126(7) 1674-1680
  • 32 Kronborg O, Fenger C, Olsen J et al. Randomised study of screening for colorectal cancer with faecal-occult-blood test.  Lancet. 1996;  348(9040) 1467-1471
  • 33 Manfredi S, Piette C, Durand G et al. Colonoscopy results of a French regional FOBT-based colorectal cancer screening program with high compliance.  Endoscopy. 2008;  40(5) 422-427
  • 34 Steele R J, McClements P L, Libby G et al. Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer.  Gut. 2009;  58(4) 530-535
  • 35 Harewood G C. Relationship of colonoscopy completion rates and endoscopist features.  Dig Dis Sci. 2005;  50(1) 47-51
  • 36 Radaelli F, Meucci G, Sgroi G, Minoli G. Technical performance of colonoscopy: the key role of sedation/analgesia and other quality indicators.  Am J Gastroenterol. 2008;  103(5) 1122-1130
  • 37 Wexner S D, Garbus J E, Singh J J. A prospective analysis of 13,580 colonoscopies. Reevaluation of credentialing guidelines.  Surg Endosc. 2001;  15(3) 251-261
  • 38 Bressler B, Paszat L F, Chen Z et al. Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis.  Gastroenterology. 2007;  132(1) 96-102
  • 39 Rabeneck L, Paszat L F, Saskin R. Endoscopist specialty is associated with incident colorectal cancer after a negative colonoscopy.  Clin Gastroenterol Hepatol. 2010;  8(3) 275-279
  • 40 Fracchia M, Senore C, Armaroli P et al. Assessment of the multiple components of the variability in the adenoma detection rate in sigmoidoscopy screening, and lessons for training.  Endoscopy. 2010;  42(6) 448-155
  • 41 Dellon E S, Lippmann Q K, Galanko J A et al. Effect of GI endoscopy nurse experience on screening colonoscopy outcomes.  Gastrointest Endosc. 2009;  70(2) 331-343
  • 42 van Putten P G, van Leerdam M E, Kuipers E J. The views of gastroenterologists about the role of nurse endoscopists, especially in colorectal cancer screening.  Aliment Pharmacol Ther. 2009;  29(8) 892-897
  • 43 Rex D K, Petrini J L, Baron T H et al. Quality indicators for colonoscopy.  Gastrointest Endosc. 2006;  63(4) 16-28
  • 44 Johnson D A, Gurney M S, Volpe R J et al. A prospective study of the prevalence of colonic neoplasms in asymptomatic patients with an age-related risk.  Am J Gastroenterol. 1990;  85(8) 969-74
  • 45 Marshall J B, Barthel J S. The frequency of total colonoscopy and terminal ileal intubation in the 1990 s.  Gastrointest Endosc. 1993;  39(4) 518-520
  • 46 Anderson J C, Messina C R, Cohn W et al. Factors predictive of difficult colonoscopy.  Gastrointest Endosc. 2001;  54(5) 558-562
  • 47 Kim W H, Cho Y J, Park J Y et al. Factors affecting insertion time and patient discomfort during colonoscopy.  Gastrointest Endosc. 2000;  52(5) 600-605
  • 48 Shah H A, Paszat L F, Saskin R et al. Factors associated with incomplete colonoscopy: a population-based study.  Gastroenterology. 2007;  132(7) 2297-2303
  • 49 Rex D K. Achieving cecal intubation in the very difficult colon.  Gastrointest Endosc. 2008;  67(6) 938-944
  • 50 Baumann U A. Water intubation of the sigmoid colon: water instillation speeds up left-sided colonoscopy.  Endoscopy. 1999;  31(4) 314-317
  • 51 Leung F W, Aharonian H S, Leung J W et al. Impact of a novel water method on scheduled unsedated colonoscopy in U.S. veterans.  Gastrointest Endosc. 2009;  69(3 Pt 1) 546-550
  • 52 Witte T N, Enns R. The difficult colonoscopy.  Can J Gastroenterol. 2007;  21(8) 487-490
  • 53 Barclay R L, Vicari J J, Doughty A S et al. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy.  N Engl J Med. 2006;  355(24) 2533-2541
  • 54 The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002.  Gastrointest Endosc. 2003;  58(6 Suppl) 3-43
  • 55 Riley S. Colonoscopic polypectomy and endoscopic mucosal resection: a practical guide. http://www bsg org uk/pdf_word_docs/polypectomy_08 pdf 2008
  • 56 Moran S S, Torrella E, Esteban D P et al. Colonoscopy quality assessment.  Rev Esp Enferm Dig. 2009;  101(2) 107-6
  • 57 Levy M J, Anderson M A, Baron T H et al. Position statement on routine laboratory testing before endoscopic procedures.  Gastrointest Endosc. 2008;  68(5) 827-832
  • 58 Carpenter S, Petersen B T, Chuttani R et al. Polypectomy devices.  Gastrointest Endosc. 2007;  65(6) 741-749
  • 59 Chino A, Karasawa T, Uragami N et al. A comparison of depth of tissue injury caused by different modes of electrosurgical current in a pig colon model.  Gastrointest Endosc. 2004;  59(3) 374-379
  • 60 Mann N S, Mann S K, Alam I. The safety of hot biopsy forceps in the removal of small colonic polyps.  Digestion. 1999;  74-6 Ref Type: Generic
  • 61 Uraoka T, Fujii T, Saito Y et al. Effectiveness of glycerol as a submucosal injection for EMR.  Gastrointest Endosc. 2005;  61(6) 736-740
  • 62 di Giorgio P, de Luca L, Calcagno G. Detachable snare versus epinephrine injection in the prevention of postpolypectomy bleeding: a randomized and controlled study.  Endoscopy. 2004;  860-863 Ref Type: Generic
  • 63 Paspatis G A, Paraskeva K, Theodoropoulou A et al. A prospective, randomized comparison of adrenaline injection in combination with detachable snare versus adrenaline injection alone in the prevention of postpolypectomy bleeding in large colonic polyps.  Am J Gastroenterol. 2006;  101(12) 2805
  • 64 Brooker J C, Saunders B P, Shah S G et al. Treatment with argon plasma coagulation reduces recurrence after piecemeal resection of large sessile colonic polyps: a randomized trial and recommendations.  Gastrointest Endosc. 2002;  55(3) 371-375
  • 65 Miller K, Waye J D. Polyp retrieval after colonoscopic polypectomy: use of the Roth Retrieval Net.  Gastrointest Endosc. 2001;  54(4) 505-507
  • 66 Banez A V, Bozek S A, Simon R F. A double endoscope method for multiple colonic polypectomy.  Gastrointest Endosc. 1987;  33(1) 30-32
  • 67 Waye J. It ain't over til it's over: retrieval of polyps after colonoscopic polypectomy.  Gastrointest Endosc. 2005;  62(2) 257-259
  • 68 Rex D K, Bond J H, Winawer S et al. Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer.  Am J Gastroenterol. 2002;  97(6) 1296-1308
  • 69 Patnick J, Segnan N, von Karsa L. European Guidelines for Quality Assurance in Colorectal Cancer Screening 2010. 
  • 70 Ko C W, Riffle S, Michaels L et al. Serious complications within 30 days of screening and surveillance colonoscopy are uncommon.  Clin Gastroenterol Hepatol. 2010;  8(2) 166-173
  • 71 Rathgaber S W, Wick T M. Colonoscopy completion and complication rates in a community gastroenterology practice.  Gastrointest Endosc. 2006;  64(4) 556-562
  • 72 Arora G, Mannalithara A, Singh G et al. Risk of perforation from a colonoscopy in adults: a large population-based study.  Gastrointest Endosc. 2009;  69(3 Pt 2) 654-664
  • 73 Park D I, Kim H J, Park J H et al. Factors affecting abdominal pain during colonoscopy.  Eur J Gastroenterol Hepatol. 2007;  19(8) 695-699
  • 74 Dobrowolski S, Dobosz M, Babicki A et al. Blood supply of colorectal polyps correlates with risk of bleeding after colonoscopic polypectomy.  Gastrointest Endosc. 2006;  63(7) 1004-1009
  • 75 Heldwein W, Dollhopf M, Rosch T et al. The Munich Polypectomy Study (MUPS): prospective analysis of complications and risk factors in 4000 colonic snare polypectomies.  Endoscopy. 2005;  37(11) 1116-1122
  • 76 Lorenzo-Zuniga V, Moreno de Vega V, Domenech E et al. Endoscopist experience as a risk factor for colonoscopic complications.  Colorectal Dis. 2010;  12 273-277
  • 77 Rabeneck L, Paszat L F, Hilsden R J et al. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice.  Gastroenterology. 2008;  135(6) 1899-906,1906
  • 78 Dobrowolski S, Dobosz M, Babicki A et al. Prophylactic submucosal saline-adrenaline injection in colonoscopic polypectomy: prospective randomized study.  Surg Endosc. 2004;  18(6) 990-993
  • 79 Folwaczny C, Heldwein W, Obermaier G et al. Influence of prophylactic local administration of epinephrine on bleeding complications after polypectomy.  Endoscopy. 1997;  29(1) 31-33
  • 80 Hsieh Y H, Lin H J, Tseng G Y et al. Is submucosal epinephrine injection necessary before polypectomy? A prospective, comparative study.  Hepatogastroenterology. 2001;  48(41) 1379-1382
  • 81 Lee S H, Lee K S, Park Y S et al. Submucosal saline-epinephrine injection in colon polypectomy: appropriate indication.  Hepatogastroenterology. 2008;  55(86 – 87) 1589-1593
  • 82 Shirai M, Nakamura T, Matsuura A et al. Safer colonoscopic polypectomy with local submucosal injection of hypertonic saline-epinephrine solution.  Am J Gastroenterol. 1994;  89(3) 334-338
  • 83 Kouklakis G, Mpoumponaris A, Gatopoulou A et al. Endoscopic resection of large pedunculated colonic polyps and risk of postpolypectomy bleeding with adrenaline injection versus endoloop and hemoclip: a prospective, randomized study.  Surg Endosc. 2009;  23 2732-2737
  • 84 Dominitz J A, Eisen G M, Baron T H et al. Complications of colonoscopy.  Gastrointest Endosc. 2003;  57(4) 441-445
  • 85 Morris M L, Tucker R D, Baron T H. Electrosurgery in gastrointestinal endoscopy: principles to practice.  Am J Gastroenterol. 2009;  104(6) 1563-1574
  • 86 Waye J D, Lewis B S, Yessayan S. Colonoscopy: a prospective report of complications.  J Clin Gastroenterol. 1992;  15(4) 347-351
  • 87 Early D S, Saifuddin T, Johnson J C et al. Patient attitudes toward undergoing colonoscopy without sedation.  Am J Gastroenterol. 1999;  94(7) 1862-1865
  • 88 Rex D K, Imperiale T F, Portish V. Patients willing to try colonoscopy without sedation: associated clinical factors and results of a randomized controlled trial.  Gastrointest Endosc. 1999;  49(5) 554-559
  • 89 Wehrmann T, Riphaus A. Sedation, surveillance, and preparation.  Endoscopy. 2009;  41(1) 86-90
  • 90 The u se. Council on Scientific Affairs, American Medical Association.  JAMA. 1993;  270(12) 1463-1468
  • 91 Vargo J J, Cohen L B, Rex D K, Kwo P Y. Position statement: nonanesthesiologist administration of propofol for GI endoscopy.  Gastrointest Endosc. 2009;  70(6) 1053-1059
  • 92 Wang A, Hoda K M, Holub J L, Eisen G M. Does level of sedation impact detection of advanced neoplasia?.  Dig Dis Sci. 2010;  55(8) 2337-2343
  • 93 Shumaker D A, Zaman A, Katon R M. Use of a variable-stiffness colonoscope allows completion of colonoscopy after failure with the standard adult colonoscope.  Endoscopy. 2002;  34(9) 711-714
  • 94 Campillo-Soto A, Pellicer-Franco E, Parlorio-Andres E et al. [CT colonography vs. barium enema for the preoperative study of colorectal cancer in patients with incomplete colonoscopy].  Med Clin (Barc ). 2007;  129(19) 725-728
  • 95 Rosman A S, Korsten M A. Meta-analysis comparing CT colonography, air contrast barium enema, and colonoscopy.  Am J Med. 2007;  120(3) 03-210
  • 96 Sosna J, Sella T, Sy O et al. Critical analysis of the performance of double-contrast barium enema for detecting colorectal polyps ≥ 6 mm in the era of CT colonography.  AJR Am J Roentgenol. 2008;  190(2) 374-385
  • 97 Johnson C D, Chen M H, Toledano A Y et al. Accuracy of CT colonography for detection of large adenomas and cancers.  N Engl J Med. 2008;  359(12) 1207-1217
  • 98 Kim D H, Pickhardt P J, Taylor A J et al. CT colonography versus colonoscopy for the detection of advanced neoplasia.  N Engl J Med. 2007;  357(14) 1403-1412
  • 99 Pickhardt P J, Choi J R, Hwang I et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults.  N Engl J Med. 2003;  349(23) 2191-2200
  • 100 Ajaj W, Lauenstein T C, Pelster G et al. MR colonography in patients with incomplete conventional colonoscopy.  Radiology. 2005;  234(2) 452-9
  • 101 Hartmann D, Bassler B, Schilling D et al. Incomplete conventional colonoscopy: magnetic resonance colonography in the evaluation of the proximal colon.  Endoscopy. 2005;  37(9) 816-820
  • 102 Wong T Y, Lam W W, So N M et al. Air-inflated magnetic resonance colonography in patients with incomplete conventional colonoscopy: Comparison with intraoperative findings, pathology specimens, and follow-up conventional colonoscopy.  Am J Gastroenterol. 2007;  102(1) 6-63
  • 103 Nelson D B. Infectious disease complications of GI endoscopy: part II, exogenous infections.  Gastrointest Endosc. 2003;  57(6) 695-711
  • 104 Multi-society guideline for reprocessing flexible gastrointestinal endoscopes.  Gastrointest Endosc. 2003;  58(1) 1-8
  • 105 Cronmiller J R, Nelson D K, Salman G et al. Antimicrobial efficacy of endoscopic disinfection procedures: a controlled, multifactorial investigation.  Gastrointest Endosc. 1999;  50(2) 152-158
  • 106 Fraser V J, Zuckerman G, Clouse R E et al. A prospective randomized trial comparing manual and automated endoscope disinfection methods.  Infect Control Hosp Epidemiol. 1993;  14(7) 383-389
  • 107 Ortiz V, Sala T, Arguello L et al. [Comparison of the efficacy of cleaning and disinfection of videoscopes: mechanized versus manual].  Gastroenterol Hepatol. 2000;  23(9) 412-415
  • 108 Santolaria S, Ducons J, Bordas J M. [Cleaning and disinfection in gastrointestinal endoscopy].  Gastroenterol Hepatol. 2007;  30(1) 25-35
  • 109 Beilenhoff U, Neumann C S, Biering H et al. ESGE/ESGENA guideline for process validation and routine testing for reprocessing endoscopes in washer-disinfectors, according to the European Standard prEN ISO 15 883 parts 1, 4 and 5.  Endoscopy. 2007;  39(1) 85-94
  • 110 Beilenhoff U, Neumann C S, Rey J F et al. ESGE-ESGENA guideline for quality assurance in reprocessing: microbiological surveillance testing in endoscopy.  Endoscopy. 2007;  39(2) 175-181
  • 111 Radaelli F, Meucci G, Terruzzi V et al. Single bolus of midazolam versus bolus midazolam plus meperidine for colonoscopy: a prospective, randomized, double-blind trial.  Gastrointest Endosc. 2003;  57(3) 329-335
  • 112 Willey J, Vargo J J, Connor J T et al. Quantitative assessment of psychomotor recovery after sedation and analgesia for outpatient EGD.  Gastrointest Endosc. 2002;  56(6) 810-816
  • 113 Simon M A, Bordas J M, Campo R et al. [Consensus document of the Spanish Association of Gastroenterology on sedoanalgesia in digestive endoscopy].  Gastroenterol Hepatol. 2006;  29(3) 131-149
  • 114 Bretthauer M, Hoff G, Severinsen H et al. [Systematic quality control programme for colonoscopy in an endoscopy centre in Norway].  Tidsskr Nor Laegeforen. 2004;  124(10) 1402-1405
  • 115 Johanson J F, Schmitt C M, Deas T M et al. Quality and outcomes assessment in Gastrointestinal Endoscopy.  Gastrointest Endosc. 2000;  52(6 Pt 1) 827-830
  • 116 Cohen L B, Delegge M H, Aisenberg J et al. AGA Institute review of endoscopic sedation.  Gastroenterology. 2007;  133(2) 675-701