Colonoscopy Performed by a Family Physician. A Case Series of 751 Procedures

J Fam Pract. 1997 May;44(5):473-80.

Abstract

Background: Colonoscopy, including biopsy and polypectomy, is a procedure not commonly performed by primary care physicians. The purpose of this research was to present a large case series of colonoscopic procedures performed by a family physician in a rural practice.

Methods: A chart review of every colonoscopy procedure performed by a family physician over a 7-year period determined the demographic characteristics, indications, findings, and complications for each procedure.

Results: A total of 751 colonoscopies were performed on 555 patients (347 women and 208 men), with a mean age of 53.8 years. In 91.5% of procedures, the cecum was intubated. The most common indications for colonoscopy were bleeding (49.9%), polyp follow-up (20.9%) abdominal pain (11.7%), diarrhea (11.6%), and abnormal findings on flexible sigmoidoscopy (8.4%). Three hundred sixteen benign polyps were discovered and removed by either biopsy or polypectomy. There were 184 adenomatous colorectal polyps found in 134 (17.8%) colonoscopies. Of these 184 adenomatous polyps, 106 (58%) were potentially within reach of the flexible sigmoidoscope. Only three adenocarcinomas were discovered during the entire study period. There was only one major procedural complication: a patient experienced blood oozing from a polypectomy stump; cautery stopped the bleeding, and the patient was hospitalized overnight, with no further intervention or transfusion required. There were five other self-limited complications, including adverse reactions to sedation and infiltration at the intravenous site.

Conclusions: Colonoscopy with polypectomy that was safely and competently performed in a solo rural practice adds to the evidence that experienced family physicians can provide this important service to their community.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / epidemiology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Colonic Neoplasms / diagnosis
  • Colonic Neoplasms / epidemiology
  • Colonic Polyps / diagnosis
  • Colonic Polyps / surgery
  • Colonoscopy* / adverse effects
  • Colonoscopy* / standards
  • Colonoscopy* / statistics & numerical data
  • Family Practice* / standards
  • Family Practice* / statistics & numerical data
  • Female
  • Georgia / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Physicians, Family / education
  • Physicians, Family / standards
  • Private Practice
  • Retrospective Studies
  • Rural Health