Average risk patients undergoing screening colonoscopies performed by 12 gastroenterologists, without fellows, were included. We compared colonoscopies performed by gastroenterologists who were only on call the night prior and colonoscopies performed by gastroenterologists
who were on call the night prior and performed emergent procedures between 8 PM and 8 AM to colonoscopies performed by the same individuals between 7/1/10 to 3/31/12. For all procedures, we compared patient demographic information and accepted quality measures. 9,307 eligible colonoscopies were included. selleck Between 7/1/10 to 3/31/12, 447 colonoscopies (mean patient age 56±6.7, 46% male) were performed by gastroenterologists on call the night prior but did not perform an emergent procedure, 126 colonoscopies (mean age 56±6.1, 44% male) were performed by gastroenterologists who had completed on call emergent procedures the night prior and 8,734 control colonoscopies (mean age 56±6.7, 48% male) were completed. There was a significantly lower percent of patients screened with adenomas detected in those procedures performed by endoscopists, who had performed emergent on call procedures the night prior, compared to the controls, 30% vs 39% respectively (P=0.043). The
mean withdrawal time for these colonoscopies was significantly longer than the control procedures, 15.5 vs 14.0 min (P=0.025), however, the mean cecal intubation times and rates were similar, 8.7 vs 8.7 min (P=0.957), 99.2% vs 99.3% (P=0.552) respectively. For the colonoscopies performed by endoscopists who were on call the PARP inhibition night prior but did not perform an emergent procedure, there was no significant difference
in the percent of patients screened stiripentol with adenomas detected compared to controls, 42% vs 39% respectively (P=0.136). There were no complications in the procedures performed by the on call endoscopists. 1) Despite longer withdrawal times, being on call the night prior and performing an emergent procedure lead to a significant 24% decrease in the adenoma detection rates among academic gastroenterologist at a large tertiary care center. 2) Being on call the night prior but not performing an emergent procedure did not influence adenoma detection rates. 3) It is imperative for screening programs to be aware of the influence of sleep deprivation and excess hour work load on procedural outcomes and consider altering their practice accordingly. “
“Probe-based Confocal Laser Endomicroscopy (pCLE) is an imaging technology enabling in vivo microscopic evaluation of live tissues, in real-time, during an endoscopic procedure. Few studies have addressed the evaluation of the learning curve for this technology. Our aims were: 1) to evaluate the learning curve in a large sample of gastroenterologists naive to pCLE, 2) to compare trainees (with limited endoscopic experience) and confirmed GI specialists (with large endoscopic experience).