BACKGROUND: Recent studies have shown the adenoma detection rate (ADR) to decrease from endoscopist fatigue. OBJECTIVE: Our primary objective was to evaluate the afternoon ADR in half-day versus full-day blocks. Secondary objectives were to determine whether time or complexity of prior procedures (modified queue position) influence ADR. DESIGN: Retrospective chart review on consecutive colonoscopies. SETTING: Tertiary-care teaching hospital. PATIENTS: This study involved all patients in our database who were over age 45 and who underwent screening and surveillance colonoscopies. MAIN OUTCOME MEASUREMENT: ADR. RESULTS: A total of 3085 patients were included in the study, with an overall 31% ADR. Of these procedures, 2148 (70%) were done in the morning, and 937 (30%) were done in the afternoon (512 full-day block, 425 half-day block). By multivariate analysis, there was no difference in ADR between full-day blocks compared with afternoon-only blocks (35% vs 32%; odds ratio [OR] 1.1; 95% confidence interval [CI], 0.8-1.5; P = .2). For all afternoon colonoscopies, no decrease in ADR was noted with increasing queue position (P = .9) or time (P = .3). In addition, no difference was found comparing ADR between all afternoon colonoscopies versus morning colonoscopies (33% vs 30%; OR 1.1; CI, 1.0-1.3; P = .1). No difference was found for advanced adenomas and number of adenomas between either afternoon-only blocks versus afternoon colonoscopy in full-day blocks or morning versus all afternoon cases. LIMITATIONS: Retrospective study; not all withdrawal times were recorded; trainees performed some of the procedures. CONCLUSION: Our data show that colonoscopy can be performed in full-day blocks and 30-minute slots without compromising ADR. Copyright Â
BACKGROUND: Recent studies have shown the adenoma detection rate (ADR) to decrease from endoscopist fatigue. OBJECTIVE: Our primary objective was to evaluate the afternoon ADR in half-day versus full-day blocks. Secondary objectives were to determine whether time or complexity of prior procedures (modified queue position) influence ADR. DESIGN: Retrospective chart review on consecutive colonoscopies. SETTING: Tertiary-care teaching hospital. PATIENTS: This study involved all patients in our database who were over age 45 and who underwent screening and surveillance colonoscopies. MAIN OUTCOME MEASUREMENT: ADR. RESULTS: A total of 3085 patients were included in the study, with an overall 31% ADR. Of these procedures, 2148 (70%) were done in the morning, and 937 (30%) were done in the afternoon (512 full-day block, 425 half-day block). By multivariate analysis, there was no difference in ADR between full-day blocks compared with afternoon-only blocks (35% vs 32%; odds ratio [OR] 1.1; 95% confidence interval [CI], 0.8-1.5; P = .2). For all afternoon colonoscopies, no decrease in ADR was noted with increasing queue position (P = .9) or time (P = .3). In addition, no difference was found comparing ADR between all afternoon colonoscopies versus morning colonoscopies (33% vs 30%; OR 1.1; CI, 1.0-1.3; P = .1). No difference was found for advanced adenomas and number of adenomas between either afternoon-only blocks versus afternoon colonoscopy in full-day blocks or morning versus all afternoon cases. LIMITATIONS: Retrospective study; not all withdrawal times were recorded; trainees performed some of the procedures. CONCLUSION: Our data show that colonoscopy can be performed in full-day blocks and 30-minute slots without compromising ADR. Copyright Â
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