The Impact of the Presence of a Second Endoscopist on the Detection Rate of Colonic Lesions

Aims The adenoma detection rate (ADR) is widely recognized as a key quality indicator for colonoscopy in colorectal cancer screening. This rate is influenced by various factors, including the quality of the colonoscopy procedure and the skill of the endoscopist. The objective of our study was to assess how the presence of a second endoscopist affects the rate of lesion detection during colonoscopy.

Methods We conducted a retrospective study reviewing colonoscopy reports from 2022 to 2024, conducted as part of the evaluation of constipation. Data were collected on patient demographics, preparation quality, endoscopic findings, and the number of endoscopists involved in each procedure.

Results A total of 237 colonoscopy reports were analyzed.

The mean age of patients was 58.4 years [ 13-82 years]. The male/female sex ratio was 0.97.

Indications for colonoscopy were mainly chronic constipation, associated with melena in 8.4% of cases, with diarrhea in 7.2% of cases, and with rectorrhagia in 5.5% of cases.

A Boston score≥7, indicating adequate bowel preparation,was noted in only 36% of cases.

The lesion detection rate was 46.4%, mainly dominated by rectocolic polyps in 21.9% of cases, colonic diverticulosis in 12.7% of cases, colorectal tumor in 4.6% of cases, hemorrhoidal lesions in 3.4% of cases, familial adenomatous polyp in 1.7% of cases.

There was a significant difference in the rate of detection of endoscopic lesions between colonoscopies performed by a single endoscopist (49.1%) versus those performed with the presence of a second endoscopist (50.9%) (p=0.008).

However, good preparation (Boston score≥7) was associated with a better lesion detection rate (p=0.04).

Conclusions The adenoma detection rate is a crucial quality measure for colonoscopy. Our study demonstrated that the presence of a second endoscopist and optimal bowel preparation (Boston score≥7) significantly enhanced the detection of lesions.

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Artikel online veröffentlicht:
27. März 2025