ASGE Masterclass: Colonoscopy (Virtual Only) | January 2022-3_Shaukat

3_Shaukat_Updates surveillance prep

Pdf Summary

The document provides updates on quality indicators, bowel prep, and surveillance guidelines for colonoscopy procedures. The importance of quality is emphasized due to its effectiveness in detecting and preventing colorectal cancer, reducing missed cases, ensuring safety, and improving patient satisfaction. Additionally, quality measures are tied to reimbursement through MIPS and APMs, making it essential for high-value practice.<br /><br />The document highlights the significance of adequate bowel preparation, as inadequate prep occurs in 10-20% of cases and can lead to delays in diagnosis, wasted endoscopy slots, repeat procedures, increased costs, and lower cecal intubation rates. Various FDA-approved agents for bowel prep are listed, along with their formulations, volumes, and warnings.<br /><br />Split-dose preparation is recommended and supported by overwhelming data for its efficacy and increasing patient compliance. It is also suggested to consider a low residue diet to improve patient satisfaction. Same-day preparation for afternoon cases is deemed acceptable, and restrictions on diet are deemed unnecessary.<br /><br />Furthermore, the document introduces updated recommendations for follow-up after colonoscopy and polypectomy. For patients with 1-2 small adenomas, the recommended follow-up interval is extended to 7-10 years instead of 5-10 years due to similar colorectal cancer risk compared to normal colonoscopy and lower risk compared to the general population. For patients with 3-4 adenomas, the follow-up interval is shortened to 3-5 years. It is mentioned that personalized regimens can enhance satisfaction and adherence to follow-up recommendations.<br /><br />In summary, the document emphasizes the importance of quality indicators, adequate bowel preparation, and proper surveillance in colonoscopy procedures. It provides guidelines and recommendations based on current evidence to improve patient outcomes and optimize the value of colonoscopy as a screening and diagnostic tool for colorectal cancer.

Keywords

quality indicators

bowel prep

surveillance guidelines

colonoscopy procedures

colorectal cancer

adequate bowel preparation

follow-up recommendations

personalized regimens

patient outcomes

screening tool