Endoscopy 2022; 54(S 01): S36
DOI: 10.1055/s-0042-1744633
Abstracts | ESGE Days 2022
ESGE Days 2022 Oral presentations
15:00–16:00 Thursday, 28 April 2022 Club H. Better, faster, stonger : improving training in endoscopy.

NEWLY TRAINED ENDOSCOPISTS PERFORM HIGH QUALITY SCREENING COLONOSCOPIES AFTER INTENSIVE TRAINING AND EVEN OUTPERFORM EXPERIENCED GASTROENTEROLOGY CONSULTANTS

A.L. Schult
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
2   University of Oslo, Institute of Clinical Medicine, Oslo, Norway
3   Vestre Viken Hospital Trust Bærum, Department of Medicine, Gjettum, Norway
,
E. Botteri
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
4   Cancer Registry of Norway, Department of Research, Oslo, Norway
,
G. Hoff
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
2   University of Oslo, Institute of Clinical Medicine, Oslo, Norway
5   Telemark Hospital Trust, Department of Research and Development, Skien, Norway
,
Ø. Holme
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
6   University of Oslo, Institute of Health and Society, Oslo, Norway
7   Sørlandet Hospital Trust, Department of Medicine, Kristiansand, Norway
,
B. Seip
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
8   Telemark Hospital Trust, Department of Medicine, Skien, Norway
,
K.R. Randel
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
,
O. Darre-Næss
3   Vestre Viken Hospital Trust Bærum, Department of Medicine, Gjettum, Norway
,
T. Owen
9   Østfold Hospital Trust, Department of Medicine, Grålum, Norway
,
J.A. Nilsen
3   Vestre Viken Hospital Trust Bærum, Department of Medicine, Gjettum, Norway
,
D.H. Nguyen
9   Østfold Hospital Trust, Department of Medicine, Grålum, Norway
,
K. Johansen
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
,
T. de Lange
10   Vestre Viken Hospital Trust Bærum, Department of Medical Research, Gjettum, Norway
11   Sahlgrenska University Hospital, Department of Medicine, Mölndal, Sweden
12   Sahlgrenska Academy, University of Gothenburg, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
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Aims High quality performance is essential for patient outcome. The need for colonoscopies is increasing and new endoscopists need to be trained. Most endoscopy trainees are considered colonoscopy competent after 275 procedures. The aim of this study was to investigate whether trainees then achieve similar quality as gastroenterologist consultants.

Methods This cross-sectional study including screening colonoscopies after positive faecal immunochemial test (FIT) or positive sigmoidoscopy performed between 2012 and 2020 at two Norwegian screening centres, compared colonoscopy key performance indicators for trainees immediately after an intensive training consisting of 300 colonoscopies, and consultants. Multivariable logistic and linear regression analyses, adjusting for possible confounders, were performed for the comparison of trainees and consultants. Odds ratios (OR) and regression coefficients with 95% confidence intervals (CI) were reported.

Results In total, 21 trainees performed 6,655 colonoscopies and 17 consultants performed 921 colonoscopies. Trainees had higher cecum intubation rate (OR 1.64, 95%CI 1.09-2.46), higher adenoma detection rate after positive FIT (OR 1.44, 95%CI 1.19-1.75), higher adequate polyp resection rate (OR 1.42, 95%CI 1.14-1.77) and fewer serious adverse events (significant bleedings and perforations) (OR 0.52, 95%CI 0.27-1.00), than consultants. Trainees’ withdrawal time was longer (+2.17 minutes, 95% CI 1.15–3.20). There was no difference in advanced adenoma detection rates, patient reported procedural pain and patient satisfaction.

Conclusions

Table 1

Quality indicators

Endoscopy trainees

Gastroenterology consultants

Odds ratio (95% confidence interval)

Cecum intubated in 1st colonoscopies per participant, n/N (%)

6,003/6147 (97.7)

749/778 (96.3)

1.64 (1.09–2.46)

Adenoma detected in 1st colonoscopies per participant after FIT n/N (%)

2,414/4,192 (57.6)

253/503 (50.3)

1.44 (1.19–1.75)

Adequate polyp resection, n/N (%)

9,734/10,254 (94.9)

1,122/1,205 (93.1)

1.42 (1.14–1.77)

Significant bleedings and perforations, n/N (%)

43/6655 (0.65)

12/921 (1.30)

0.52 (0.27–1.00)

Our results show that it is feasible to train endoscopists to perform high quality colonoscopies through a limited number of training colonoscopies and that trainees then even surpass experienced consultants on several key performance indicators.



Publication History

Article published online:
14 April 2022

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