Assessment of the impact of technical factors on the quality of colonoscopy – a preliminary report

Introduction: The debate over the quality of colonoscopy typically includes technical factors such as the resolution of the camera (standard vs. high definition), the physical parameters (thickness, stiffness, pediatric colonoscope vs. standard, variable stiffness endoscope) and the possibility to use additional techniques (narrow band imaging, auto fluorescence imaging, retrograde viewing device, cap-assisted colonoscopy, carbon dioxide insufflation or water infusion). The cecal intubation rate and patient tolerance of endoscopy are usually used as determinants of the quality of colonoscopy.

Aim: The study evaluated the possible impact of technical factors related to presentation of the endoscopic image on the quality measured by the polyp detection rate/adenoma detection rate (PDR/ADR). The model used in the study was constructed i the way to minimize the impact of operator-dependent factors (retrospective analysis of derived from the population routinely tested – diagnostic endoscopy done by

a single endoscopist).

Material and methods: The model used in the study was constructed in the way to minimize the impact of operator dependent factors (retrospective analysis of archival data, single endoscopist, the population of routinely examined patients – diagnostic endoscopies).

Results: The results suggest that the impact of analyzed technical factors may be statistically significant. Reported differences are limited to the smallest polyps, up to 5 mm, located in the distal intestine (tubular adenomas and hyperplastic polyps).

Conclusions: The results indicate no statistically significant difference in the "advanced adenoma" detection rate, suggesting their limited clinical significance, but drawing attention to a technical aspect that could potentially affect the results of clinical trials.