The impact of video recording colonoscopy on adenoma detection rates.

BACKGROUND

The adenoma detection rate (ADR) is a quality benchmark for colonoscopy, influenced by several factors including bowel preparation, withdrawal time, and withdrawal technique.

OBJECTIVE

To assess the impact of video recording of all colonoscopies on the ADR.

DESIGN

Comparison of two cohorts of patients undergoing colonoscopy before and after implementation of video recording.

SETTING

Academic outpatient endoscopy facility.

PATIENTS

This study involved asymptomatic, average-risk adults undergoing screening colonoscopy.

INTERVENTION

Video recording of all colonoscopy procedures. Polyp findings and withdrawal times were recorded for 208 consecutive screening colonoscopies. A policy of video recording all colonoscopies was implemented and announced to the staff. Data on another 213 screening colonoscopies were subsequently collected.

MAIN OUTCOME MEASUREMENTS

Adenoma detection rate, withdrawal time, advanced polyp detection rate, hyperplastic polyp detection rate.

RESULTS

At least one adenoma was found in 38.5% of patients after video recording versus 33.7% before video recording (P = .31). There was a significant increase in the hyperplastic polyp detection rate (44.1% vs 34.6%; P = .046). Most endoscopists had a numerical increase in their ADRs, but only one was significant (57.7% vs 22.6%; P < .01). There were trends toward higher detection of adenomas of <5 mm (59.1% vs 52%; P = .23) and right-sided adenomas (40.2% vs 30.4%; P = .11) in the video recorded group.

LIMITATIONS

No randomization, confounding of intervention effects, and sample size limitations.

CONCLUSION

Video recording of colonoscopies is associated with a nonsignificant increase in the ADR and a significant increase in the hyperplastic polyp detection rate. There may be a benefit of video recording for endoscopists with low ADRs.