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Photodocumentation in colonoscopy: the need to do better?
Frontline Gastroenterology ( IF 2.4 ) Pub Date : 2022-07-01 , DOI: 10.1136/flgastro-2021-101903
Ahmir Ahmad 1 , Brian P Saunders 1
Affiliation  

There is wide variation in the recommendations for photodocumentation at colonoscopy. The British Society of Gastroenterology (BSG) quality assurance standard suggests ‘photographic proof of ileocaecal valve, terminal ileum, anastomosis or appendix orifice [is] required in all cases’.1 Like the American Society for Gastrointestinal Endoscopy (ASGE)/American College of Gastroenterology (ACG) guidelines,2 documentation of any other part of the colon is not currently mandated. Although caecal photographs serve to confirm that the colonoscope has been passed the full length of the colon, they do not document whether the colonic mucosa has been adequately visualised. Photodocumentation is a relatively simple ‘push button’ process, and most endoscopists now have access to reporting systems that can automatically integrate multiple images in real time. A pertinent question therefore is, should we perform more comprehensive photodocumentation and will this lead to improvements in the quality and reliability of the examination? One approach to overcoming the limitations of static photodocumentation would be to video record the entire procedure, and with improvements in data storage, this is now technically possible. Video-recording has been found to increase mean inspection time by 49% and quality of mucosal inspection technique (measured by blinded assessment) by up to 30%.3 However, there are still significant data storage costs and issues arise around sharing of information with colleagues and manipulation of large data files. Given that endoscopists are familiar with photodocumentation and files are smaller and easy to embed in current software records, enhancing current practice with specific emphasis on quality and training in photodocumentation may be a more acceptable and realistic way of enhancing quality. An example of where enhanced photodocumentation has been recommended is the BSG standards for upper gastrointestinal (GI) endoscopy.4 Eight photos of anatomical landmarks are now advised. The impetus for this approach was a recognition that …

中文翻译:

结肠镜检查中的照片记录:需要做得更好吗?

在结肠镜检查中对照片记录的建议存在很大差异。英国胃肠病学会 (BSG) 质量保证标准建议“在所有情况下都需要提供回盲部瓣膜、回肠末端、吻合口或阑尾口的照片证明”。 1 与美国胃肠内镜学会 (ASGE)/美国医学会胃肠病学 (ACG) 指南 2 目前没有强制要求记录结肠的任何其他部分。尽管盲肠照片用于确认结肠镜已经通过了结肠的全长,但它们并没有记录结肠粘膜是否已经充分可视化。照片记录是一个相对简单的“按钮”过程,大多数内镜医师现在都可以使用可以实时自动整合多个图像的报告系统。因此,一个相关的问题是,我们是否应该进行更全面的照片记录,这是否会导致考试质量和可靠性的提高?克服静态照片文档限制的一种方法是视频记录整个过程,并且随着数据存储的改进,这在技术上是可行的。已发现视频记录可将平均检查时间增加 49%,将黏膜检查技术的质量(通过盲法评估衡量)增加多达 30%。3 但是,仍然存在大量数据存储成本,并且在与信息共享方面存在问题同事和大数据文件的操作。鉴于内窥镜医师熟悉照片文档,并且文件更小且易于嵌入当前的软件记录中,加强当前的实践,特别强调照片文档的质量和培训,可能是提高质量的一种更可接受和更现实的方式。上消化道 (GI) 内窥镜检查的 BSG 标准是推荐增强照片记录的一个例子。4 现在建议使用八张解剖标志的照片。这种方法的推动力是认识到……
更新日期:2022-06-07
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