Adherence to ESGE Guidelines for colonoscopy photo-documentation: A single centre audit in Letterkenny University Hospital

Aims We aimed to review the photo documentation performed during colonoscopy in our unit and audit compliance with ESGE guidelines. Photo documentation, an integral part of quality control in colonoscopy, not only demonstrates crucial anatomic landmarks, records the extent of the examination and displays the quality of prep and mucosal visualisation but also has the potential to impact patient outcomes significantly. It provides objective evidence and a visual description, which is helpful for communication with colleagues and patients. With the increasing awareness of post-colonoscopy colorectal cancer, with rates as high as 7.4%¹, there is an urgent need for meticulous examination and documentation during colonoscopy procedures. Due to the wide availability of digital systems, it is easier than ever to complete photo documentation. The ESGE guidelines suggest that nine areas should be captured in each colonoscopy, though there is no clear-cut evidence at the moment to suggest that doing so improves diagnostic yield.

Methods We examined colonoscopy reports over one month in June 2024 to see the extent of photo documentation and adherence to the guidelines. We also evaluated the demographics of the population, indication for scope, endoscopy findings, and rank of person completing the colonoscopy. We then assessed this data to see how many reports included the recommended landmarks and which sites were most commonly documented. Data analysis was completed using Excel [1].

Results 299 reports of completed colonoscopies were analysed. All nine views were included in 2% (n=6); however, in 7% (n=22) of reports, none of the landmarks were included. The mean number of areas documented was calculated at 2.85. The most commonly documented area was the ICV at 77% (n=229). The least commonly documented area was the transverse colon before the hepatic flexure at 7% (n=22). The most common indication was rectal bleeding. The indication which resulted in the highest mean number of photos was chronic diarrhoea at 4.43, and the indication with the lowest mean was prior malignancy at 1.88.

Conclusions Our study revealed low compliance with the guidelines in our centre and significant variation between clinicians in terms of the degree of photo documentation completed. However, we are optimistic about the potential for improvement. We plan to organise an education session on the benefits of photo documentation and the ESGE guidelines, aiming to re-audit later in the year. This re-audit presents an opportunity for us to measure the impact of our education session and the potential for increased compliance.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 Burr NE, Derbyshire E, Taylor J. et al. Variation in post-colonoscopy colorectal cancer across colonoscopy providers in English National Health Service: population-based cohort study. BMJ 2019; 367: l6090