Colonoscopy by a family physician: a 9-year experience of 1048 procedures.
J Fam Pract
; 43(6): 561-6, 1996 Dec.
Article
em En
| MEDLINE
| ID: mdl-8969704
ABSTRACT
BACKGROUND:
In the last 15 years, family physicians and general internists have adopted flexible fiberoptic endoscopy as a procedure to screen patients at risk of premature death from colorectal cancer. There has been controversy regarding the ability of non-fellowship-trained primary care physicians to extend this experience to full colonoscopy.METHODS:
The results of 1048 consecutive colonoscopy examinations performed by a family physician over a 9-year period were tabulated. Outcomes measured included the reach-the-cecum rate (RCR), use of medication, complication rate, and diagnostic yield. In a convenience sample of 110 cases, the effectiveness of the non-narcotic analgesic ketorolac was assessed by the RCR. Outcomes of cases in which ketorolac was used were compared with cases in which traditional sedation and analgesia were used.RESULT:
A high diagnostic yield without significant complications was noted. The RCR for nonmedicated patients was 36%. Among all medicated cases, the RCR was 93%. In patients who were given the non-narcotic analgesic ketorolac, the RCR was 96%, compared with 95% in patients not given ketorolac.CONCLUSIONS:
A family physician in rural practice was able to attain and sustain a state-of-the-art, reach-the-cecum rate over a 9-year period. This service resulted in a high diagnostic yield, high degree of safety, and satisfactory results for the community. Ketorolac is an effective alternative for patients who may be hypersensitive to narcotic analgesia/sedation.
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Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Colonoscopia
/
Neoplasias do Colo
/
Medicina de Família e Comunidade
Tipo de estudo:
Diagnostic_studies
/
Evaluation_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Fam Pract
Ano de publicação:
1996
Tipo de documento:
Article