ASGE Annual GI Advanced Practice Provider Course (Virtual) - Onboarding Day One | April 2022-10_Colonoscopy the Basics

10_Colonoscopy the Basics - Vicari

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This document provides a basic overview of colonoscopy, including pre-procedure preparation, intra-procedure techniques, and post-procedure care. <br /><br />In the pre-procedure stage, timely scheduling and appropriate patient selection are important factors. Patients may be scheduled for colonoscopy for a variety of reasons, such as screening or surveillance of colon cancer/polyps, lower gastrointestinal (LGI) bleeding or symptoms, abnormal imaging, inflammatory bowel disease (IBD), or therapeutic intervention. Certain contraindications, such as the use of anticoagulants and thienopyridines, should be considered before the procedure. Patient preparation may involve moderate or deep sedation, especially for those with prior sedation difficulties or increased risk for cardiopulmonary complications. <br /><br />During the procedure, different types of colonoscopes, tissue sampling, polypectomy, tattooing, and endoscopic hemostasis may be used. Diagnostic and therapeutic maneuvers, such as dilation of strictures, stent placement, endoscopic mucosal resection, and colonic decompression tube placement, may also be performed. The most common complication during the procedure is cardiopulmonary complications related to sedation. <br /><br />After the procedure, the participation in quality data base projects, evaluation of adenoma detection rate and cecal intubation rate, and the management of post-procedure complications, such as post-polypectomy bleeding and perforation, are important. Post-polypectomy syndrome, which includes electrocautery injury to the bowel wall and focal peritonitis, may occur and requires management with intravenous fluids, antibiotics, and bowel rest. It is also important to consider the phases of colonoscopies when thinking about patient selection, sedation, complications, and the potential impact on management and outcomes.

Keywords

colonoscopy

pre-procedure preparation

intra-procedure techniques

post-procedure care

patient selection

sedation

complications

polyps

inflammatory bowel disease

post-polypectomy syndrome