Retrospective Cohort Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jun 16, 2018; 10(6): 109-116
Published online Jun 16, 2018. doi: 10.4253/wjge.v10.i6.109
Is there a difference in adenoma detection rates between gastroenterologists and surgeons?
Adele Hwee Hong Lee, Nuttaradee Lojanapiwat, Vikram Balakrishnan, Raaj Chandra
Adele Hwee Hong Lee, Nuttaradee Lojanapiwat, Eastern Health Clinical School, Monash University Clayton Campus, Melbourne 3128, Australia
Vikram Balakrishnan, Raaj Chandra, Department of Colorectal Surgery, Box Hill Hospital, Melbourne 3128, Australia
Raaj Chandra, Royal Melbourne Hospital, Melbourne 3050, Australia
Author contributions: Lee AHH and Lojanapiwat N collected, analysed and interpreted the data, drafted and revised the manuscript; Balakrishnan V interpreted the data and revised the manuscript; Chandra R conceptualised the research project, provided advice and guidance and revised the manuscript; all authors read and approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Office of Research and Ethics at Eastern Health.
Informed consent statement: Informed consent was waived by the Office of Research and Ethics due to the retrospective nature of the study, the large number of patients, and considering that the rights and welfare of the subjects will not be adversely affected by this research.
Conflict-of-interest statement: The authors report no conflict of interest.
Data sharing statement: Sharing of data could be requested from the corresponding author at adelelee396@gmail.com. Data will be provided in an anonymized manner with no risk of identification.
STROBE statement: The guidelines of the STROBE statement has been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adele Hwee Hong Lee, Doctor, MBBS, Medical Student, Eastern Health Clinical School, Monash University Clayton Campus, 5 Arnold St, Box Hill, Melbourne 3128, Australia. adelelee396@gmail.com
Telephone: +61-41-5686448
Received: January 5, 2018
Peer-review started: January 5, 2018
First decision: January 31, 2018
Revised: March 5, 2018
Accepted: April 11, 2018
Article in press: April 11, 2018
Published online: June 16, 2018
Processing time: 161 Days and 5.9 Hours
Abstract
AIM

To compare the adenoma detection rate (ADR) between gastroenterologists and colorectal surgeons at Box Hill Hospital, Melbourne, Australia.

METHODS

A total of 300 colonoscopies performed by gastroenterologists and colorectal surgeons at Box Hill Hospital were retrospectively reviewed from May 2016 to June 2017. Exclusion criteria were: Patients ≤ 50 years old, colonoscopies with failure of caecal intubation, patients who previously had colon cancer and/or a colonic resection, history of polyposis syndromes or inflammatory bowel disease, or a colonoscopy within the last 10 years. Patient demographics, indications, symptoms and procedural-related outcomes were measured.

RESULTS

The ADR was not significantly different between gastroenterologists and colorectal surgeons (34% vs 34.67%; P = 0.90). The adjusted odds ratio correcting for gender, age, 1st degree relative with colorectal cancer, previous colonoscopy, trainee involvement and caecal or terminal ileum intubation rate was 1.19 (0.69-2.05).

CONCLUSION

Both specialties at our institution exceed benchmark standards suggested by published Australian and American guidelines. An association between endoscopist specialty and ADR was not observed.

Keywords: Colorectal surgery; Gastroenterologists; Surgeons; Adenoma; Colonoscopy; General surgery

Core tip: Our study concludes that there is no association between specialty (gastroenterology and colorectal surgeons) and proficiency in colonoscopy, using adenoma detection rate as a quality indicator. The adenoma detection rate in both specialties at our institution exceed benchmark standards suggested by published Australian and American guidelines, reflecting the high standards of care and efficacy of the common training pathway for both specialties.