Editing Colonoscopy theory


== Risks: ==

* Serious harm in 2.8 per 1000
* And 85% of those in s/o polypectomy
* Mortality 0.007%
* Related to sedation
* Preparation
* Bleeding
* Perforation - 1 in 1000 screening, 1 in 500 for all
* Infection


Right colon lesions are more likely to be missed - more likely to be flat

Should take >6min withdrawal - more likely to find any polyp and also malignant polyp

Selective application of dye spray (eg indigocarmine) can assist with detection.

* Not routinely used since time-consuming and messy, and mostly helps find diminutive non-malignant polyps
* Useful in ulcerative colitis dysplasia detection

Narrow band imaging can be helpful with detection of flat adenomas and differentiation of malignant/benign lesionsin particular, but hasn't been shown to increase ADR for average-risk patients.

== Quality indicators (Australian Commission on Safety and Quality in Healthcare ==

* Procedure
** Whole colon and caecum examined carefully and systematically
** Document adequacy of bowel prep, clinical findings, biopsies, polyps, therapeutic interventions and adverse events. 
** Submit all polyps for histology

== GESA recertification requirements ==

* >95% of procedures to caecum or TI of intact colons
* 25% adenoma detection rate >50yo
* SSA detection rate >4% >50yo

== SCV recommendations ==

* 6 minute withdrawal time

[[Category:Endoscopy]]