E-ISSN: 2536-4901 ISSN: 2536-4898
Kolonoskopide Kalite Standartlarına Uyum ve İnkomplet Kolonoskopi Nedenleri: Prospektif Gözlemsel Çalışma
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CİLT: 29 SAYI: 1
P: 25-32
Mart 2019

Kolonoskopide Kalite Standartlarına Uyum ve İnkomplet Kolonoskopi Nedenleri: Prospektif Gözlemsel Çalışma

Turk J Colorectal Dis 2019;29(1):25-32
DOI: 10.4274/tjcd.galenos.2018.68736
Ulaş Aday 1
Ebubekir Gündeş 2
Hüseyin Çiyiltepe 3
Durmuş Ali Çetin 4
Emre Bozdağ 5
Sabiye Akbulut 6
Rabia Köksal 6
Erdal Polat 5
1. University of Health Sciences, Elazığ Training and Research Hospital, Clinic of Gastroenterological Surgery, Elazığ, Turkey
2. University of Health Sciences, Gaziyaşargil Training and Research Hospital, Clinic of Gastroenterological Surgery, Diyarbakır, Turkey
3. University of Health Sciences, Balıkesir Training and Research Hospital, Clinic of Gastroenterological Surgery, Balıkesir, Turkey
4. Şanlıurfa Training and Research Hospital, Clinic of Gastroenterological Surgery, Şanlıurfa, Turkey
5. University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Clinic of Gastroenterologcal Surgery, İstanbul, Turkey
6. University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Clinic of Gastroenterology, İstanbul, Turkey
Bilgi mevcut değil.
Bilgi mevcut değil
Alındığı Tarih: 13.08.2018
Kabul Tarihi: 12.09.2018
Yayın Tarihi: 26.03.2019
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ÖZET

Amaç:

Kolorektal patolojilerin tanısında kolonoskopi altın standarttır ve klinik uygulamalarda sık yapılan bir işlemdir. Bu çalışmada inkomplet kolonoskopi oranı, kolonoskopinin tamamlanmamasına etki eden faktörler ve kliniğimizin kolonoskopi kalite standartlarına uygunluğunun değerlendirilmesi amaçlanmıştır.

Yöntem:

Çalışma Ocak 2017-Aralık 2017 tarihleri arasında üçüncü basamak sağlık merkezinde prospektif olarak yapıldı. Kolonoskopi yapılan bireylerin demografik özellikleri, kolon temizlik durumu, inkomplet kolonoskopi nedenleri ve inkomplet kolonoskopiye etki eden faktörler incelendi. Kolonoskopisi tamamlanan ve tamamlanmayan popülasyon karşılaştırıldı.

Bulgular:

Toplam 756 kişi çalışmaya alındı. Yaş ortalaması 54±12,74 yıl olup %63’ü kadındı. Üç yüz kırk yedisinde (%45,9) komorbidite mevcuttu. Popülasyonun vücut kitle endeksi (VKİ) ortalaması 28,32±4,84 olup, 309’unda (%40,9) geçirilmiş batın cerrahi öyküsü vardı. Çekum entübasyon süresi 355±187 saniye olup 89 kişide (%11) kolonoskopi tamamlanamadı. İleri yaş (p=0,036), kadın cinsiyet (p=0,036), yüksek VKİ değeri (p=0,042), komorbidite varlığı (p=0,004), antiagregan/antikoagülan kullanımı (p=0,001), yetersiz barsak temizliği (p=<0,001) inkomplet kolonoskopi lehine anlamlı saptandı. Uygun barsak hazırlığı yapılamayan ve işlem tekrarı önerilen 46 (%6,1) vaka dışlandığında %93,9’unda (667/710) kolonoskopi tamamlanmıştır. Kötü barsak hazırlığı inkomplet kolonoskopinin en sık nedeni olup (%51,6), erkek cinsiyet (p=0,047) ve antiagregan-antikoagülan kullanımın (p=0,021) kolon temizliğine etki eden faktörler olarak belirlenmiştir. Kolonoskopisi tamamlanan grupta polip saptanma oranı %24,7 (165/ 667) olup güncel önerilen polip saptanma oranının altında kalmıştır.

Sonuç:

Uygun olmayan barsak temizliği, ileri yaş, kadın cinsiyet, artan VKİ, komorbidite ve antiagregan/antikoagülan kullanımı inkomplet kolonoskopiye etki eden faktörlerdir. Uygun olmayan barsak temizliğinin ana nedeni olduğu yüksek inkomplet kolonoskopi oranı ve düşük polip saptama oranı nedeniyle kolonoskopi kalite standartlarının altında kaldığımız görülmektedir.

Anahtar Kelimeler:
nkomplet kolonoskopi, barsak hazırlığı, kolonoskopide kalite

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