ASGE Masterclass: Colonoscopy (On-Demand) | January 2022-3_Shaukat

3_Shaukat_Updates surveillance prep

Pdf Summary

This document provides updates on quality indicators, bowel prep, and surveillance guidelines in the field of gastroenterology. The author emphasizes the importance of quality in terms of effective detection and prevention of colorectal cancer, reducing complications, reimbursement, and patient satisfaction. The document provides quality metrics and benchmarks for various aspects of colonoscopy, including appropriate indication documentation, informed consent, surveillance intervals, bowel prep quality, cecal intubation rates, adenoma detection rates, withdrawal time, attempted endoscopic removal of polyps, perforation rates, post-polypectomy bleeding incidence, and surveillance interval recommendations.<br /><br />The document discusses the significance of bowel prep quality and its impact on the healthcare system, such as delays in diagnosis and care, wasted endoscopy slots, repeat procedures, increased costs, lower cecal intubation rates, and decreased patient/provider experience. It provides information on FDA-approved bowel prep agents and their formulations, volume, and warnings. It also mentions non-FDA-approved regimens and their potential risks and benefits.<br /><br />The document emphasizes the overwhelming data supporting the efficacy of split-dose bowel prep and its association with increased compliance, improved tolerability, and greater willingness to repeat the prep. It mentions the use of a low residue diet for breakfast and lunch the day before the procedure and the use of water jets to improve bowel cleansing.<br /><br />The document includes recommendations for follow-up after colonoscopy and polypectomy, including intervals for patients with low-risk adenomas, advanced adenoma detection rates, and serrated polyps. It discusses the rationale and evidence behind the recommended intervals and the importance of shared decision making.<br /><br />Overall, the document highlights the importance of quality in colonoscopy procedures, provides guidelines for bowel prep, and offers recommendations for surveillance intervals based on the latest evidence.

Keywords

quality indicators

bowel prep

surveillance guidelines

colorectal cancer

complications

reimbursement

patient satisfaction

colonoscopy

cecal intubation rates

adenoma detection rates