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CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(01): 023-029
DOI: 10.1055/s-0041-1724070
Original Article

Assessment of Quality Indexes in Colonoscopy in the Coloproctology Service of a Tertiary Private Hospital in Southern Brazil

Avaliação de índices de qualidade em colonoscopia em um serviço de coloproctologia de um hospital terciário privado do Sul do Brasil
Rafael Castilho Pinto 
1   Coloproctology Service, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
,
Marcela Krug Seabra 
1   Coloproctology Service, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
,
Aline Andrea da Cunha 
2   Research Support Center, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
,
Cassia Garcia Moraes Pagano 
2   Research Support Center, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
,
Heloisa Guedes Mussnich 
1   Coloproctology Service, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
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Abstract

Background Colorectal cancer (CRC) is the third most common cancer among men, and the second among women worldwide. In Brazil, the incidence and mortality of CRC continues to increase. In colonoscopies, adenoma detection rates (ADRs) higher than 25% are associated linearly with better outcomes and lower rates of interval cancer.

Objective To assess the colonoscopy quality indexes.

Methods This is a cross-sectional retrospective study in which anatomopathological data and data regarding the colonoscopies were collected from the patient records of Hospital Moinhos de Vento, in Southern Brazil. The exams were performed by doctors from the Colorectal Service from June to August 2015.

Results A total of 430 exams were included. Most patients were women (60.9% [262]), with a mean age of 56.96 years. The cecal intubation rate was of 96.7% (416). The quality of the bowel preparation was excellent or good in 92.95% (396) of the cases. The average time of removal of the colonoscope in normal exams was of 6.15 minutes. Polyps were detected in 201 patients (46.7%), and adenomas, in 125 patients (29.1%); 12 patients (2.8%) had advanced adenomas, and 6 (2.3%) had malignant neoplasms. The proximal serrated lesion detection rate (PSLDR) was of 6.7% (29). The prevalence ratio (PR) of adenomas among men was 1.78 times greater than in women (95% confidence interval [95%CI]: 1.16–2.75). The PR of adenomas among people aged 50 years or older was 2.41 times that of those under 50 years of age (95%CI: 1.43–4.06).

Conclusion The data obtained are in line with international quality criteria in colonoscopy. More studies are needed to assess the ADR in the Brazilian population.

Resumo

Introdução O câncer colorretal (CCR) é o terceiro mais comum em homens e o segundo mais comum em mulheres em todo o mundo. A incidência e mortalidade do CRC continuam a aumentar no Brasil. Taxas de detecção de adenoma superiores a 25% em colonoscopias estão associadas linearmente a melhores resultados e menores taxas de câncer de intervalo.

Objetivo Avaliar a qualidade das colonoscopias analisadas.

Métodos Este é um estudo transversal e retrospectivo no qual dados anatomopatológicos e relacionados às colonoscopias foram coletados de registros dos pacientes do Hospital Moinhos de Vento, no Sul do Brasil. Os exames foram realizados por médicos do Serviço de Coloproctologia de junho a agosto de 2015.

Resultados Foram incluídos 430 exames. A maioria dos pacientes era do sexo feminino (60,9% [262]), com idade média de 56,96 anos. A taxa de intubação cecal foi de 96,7% (416). A qualidade do preparo intestinal foi excelente ou boa em 92,95% (396) dos casos. O tempo médio de retirada do colonoscópio em exames normais foi de 6,15 minutos. Pólipos foram detectados em 201 pacientes (46,7%), e adenomas, em 125 (29.1%); 12 pacientes (2,8%) tinham adenomas avançados, e 6 (2,3%), neoplasias malignas. A taxa de detecção de lesões serrilhadas foi de 6,7% (29). A razão prevalência (RP) de adenomas em homens foi de 1,78 vezes em relação a mulheres (intervalo de confiança de 95% [IC95%]: 1,16–2,75). A RP de adenomas entre pacientes com 50 anos ou mais foi 2,41 vezes maior do que a daqueles com mais de 50 anos (IC95%: 1,43–4,06).

Conclusão Os dados obtidos estão de acordo com os critérios internacionais de qualidade em colonoscopia. Mais estudos são necessários para avaliar as taxas de detecção de adenoma na população brasileira.

Keywords

adenoma - colorectal cancer - colonoscopy

Palavras-chave

adenoma - câncer colorretal - colonoscopia

Authors' contributions:

Pinto, RC: study design, data collection and analysis, preparation and revision of the manuscript; Seabra MK: study design and data collection; Cunha, AAd, and Pagano, CGM: statistical analysis and preparation and revision of the manuscript. Mussnich HG: study design and revision of the manuscript.




Publication History

Received: 14 July 2020

Accepted: 11 August 2020

Article published online:
19 March 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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