Endoscopist experience as a risk factor for colonoscopic complications

Colorectal Dis. 2010 Oct;12(10 Online):e273-7. doi: 10.1111/j.1463-1318.2009.02146.x.

Abstract

Aim: We aimed to determine the incidence of colonic perforation (CP) following colonoscopy and postpolypectomy bleeding (PPB) in a teaching hospital, assessing the influence of endoscopist experience as a risk factor.

Method: All colonoscopies performed between 1995 and 2008 were reviewed. Demographic data, endoscopic procedure information, incidence of CP and PPB, and endoscopist experience were recorded.

Results: In the 14-year period, 25,214 endoscopic colonic procedures were performed, and 3991 patients underwent polypectomy. The overall CP risk was 0.51/1000 procedures; and PPB 14.7/1000. The relative risk (RR) ratio of complications was 2.8/1000 procedures. The RR rate was highest for endoscopists performing less than 591 procedures per year (4.0/1000 [95% CI, 3.7-4.3] vs 2.9/1000 [95% CI, 2.6-3.2]), P < 0.001).

Conclusion: The complication rate after colonoscopy was comparable to that previously reported. Colonoscopy carried out by a low-volume endoscopist was independently associated with bleeding and perforation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Competence*
  • Colonic Diseases / epidemiology
  • Colonic Diseases / etiology*
  • Colonic Polyps / diagnosis
  • Colonic Polyps / pathology
  • Colonic Polyps / surgery*
  • Colonoscopy / adverse effects*
  • Female
  • Gastroenterology*
  • Humans
  • Intestinal Perforation / epidemiology
  • Intestinal Perforation / etiology*
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / etiology*
  • Retrospective Studies
  • Risk Factors