Endoscopy 2019; 51(04): S165-S166
DOI: 10.1055/s-0039-1681659
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 16:30 – 17:00: Preparation: sedation 1 ePoster Podium 7
Georg Thieme Verlag KG Stuttgart · New York

OUTCOMES OF COLONOSCOPY WITH NON-ANESTHESIOLOGIST ADMINISTERED PROPOFOL (NAAP)

M Alburquerque
1   Gastroenterology, Hospital de Palamós, Palamós, Spain
2   Gastroenterology, Clínica Girona, Girona, Spain
,
A Smarrelli
1   Gastroenterology, Hospital de Palamós, Palamós, Spain
,
J Chevarria
3   Nephrology, Beaumont Hospital, Dublin, Ireland
,
S Ortega
4   Nursing Department, Hospital de Palamós, Palamós, Spain
,
A Zaragoza
4   Nursing Department, Hospital de Palamós, Palamós, Spain
,
A Vargas
1   Gastroenterology, Hospital de Palamós, Palamós, Spain
2   Gastroenterology, Clínica Girona, Girona, Spain
,
C Ledezma
1   Gastroenterology, Hospital de Palamós, Palamós, Spain
,
L Vidal
1   Gastroenterology, Hospital de Palamós, Palamós, Spain
,
M Figa
2   Gastroenterology, Clínica Girona, Girona, Spain
5   Gastroenterology, Hospital Universitario Dr Josep Trueta, Girona, Spain
,
F González-Huix
2   Gastroenterology, Clínica Girona, Girona, Spain
6   Gastroenterology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

To determine the equivalence of adenoma detection rate (ADR) in colorectal cancer (CRC) screening colonoscopies performed with NAAP and performed with monitored anesthesia care (MAC).

Methods:

Single blind non-randomized controlled equivalence trial.

Patients:

Adults between 50 – 69 years old from National CRC screening program (CRCSP).

Intervention:

Patients were blindly assigned to undergo either colonoscopy with NAAP or MAC by CRCSP office according to the arrival of fecal occult blood test, patient's suitability for colonoscopy date and availability of places at endoscopy schedule (with NAAP or MAC).

Main outcome measure:

The ADR in CRCSP colonoscopies performed with NAAP.

Results:

We included 315 patients per group. Age: 59.76 ± 5.81y, 40.5% women. Two endoscopists (E1 and E2) with an experience over 1 year in CRCSP performed the colonoscopies. The cecal intubation rate (CIR) was 97%, adequate bowel preparation (ABP): 81.8%, withdrawal time > 6 min (WT6 m): 98.7% and global exploration time (ET): 24.25 ± 8.86 min (8 – 70 min). The ADR was 62.9%, advanced ADR (aADR): 37.3%, sessile serrated ADR (ssADR): 5.2% and mean adenomas per procedure (MAP): 1.53 ± 1.75. The complication rate (CR) was 0.6%. The E1 registered a superior CIR (98.41% vs. 91.34%, p = 0.01) ADR (64.61% vs. 55,91%, p = 0.08) and MAP (1.63 ± 1.81 vs. 1.15 ± 1.45, p = 0.01).

Analysis by intention to treat showed an ADR in colonoscopies performed with NAAP of 64.13% compared with 61.59% performed with MAC, difference (ΔADR): 2.54%, 95% confidence interval (95% CI): –0.10 to 0.05. Analysis by per protocol showed an ADR in colonoscopies performed with NAAP of 62.98% compared with 61.94% performed with MAC. ΔADR: 1.04%, 95% CI: –0.09 to 0.07. There were no differences in the CR between NAAP and MAC in both analyses.

Conclusions:

The ADR in colorectal cancer screening colonoscopies performed with NAAP is equivalent to ADR in colonoscopies performed with MAC. Similarly, there is no difference in the complication rate.