Öz
Amaç: Bu çalışmada eğitim düzeyinin bağırsak temizliği üzerinde etkisi olup olmadığı araştırıldı.
Gereç ve yöntemler: İzmir Tepecik Eğitim ve Araştırma Hastanesi Gastroenteroloji Bölümü Endoskopi Biriminde 01 Ağustos 2015-30 Kasım 2015 tarihleri arasında herhangi bir nedenle kolonoskopi uygulanan 100 hasta (54 erkek, 46 kadın; ort. yaş 55±14 yıl; dağılım, 19-83 yıl) retrospektif olarak değerlendirildi. Veriler hastanenin bilgisayarlı sisteminden edinildi. Hastalar yaş, cinsiyet, eğitim durumu, ayakta veya yatan hasta olmaları, kolon temizliği ve çekuma erişilip erişilememesine göre gruplandı.
Bulgular: Yirmi dokuz hasta eğitimsizdi ve 19 hasta okuryazar değildi. Çekal entübasyonun yapılamadığı 19 hastanın 10’u eğitimsizdi. Ayakta hastaların çekal entübasyon oranı (ÇEO) yatan hastalardan daha yüksekti (%84’e karşın %54 ve p=0.002). Çekal entübasyon oranı okuryazar olmayan hastalarda okuryazar hastalardan daha düşüktü (%57’ye karşın %86 ve p=0.008). Çekal entübasyon oranı eğitimsiz hastalarda eğitimli hastalardan daha düşüktü (%65’e karşın %87 ve p=0.01). Üniversite mezunu tüm hastalarda çekuma erişildi. Yetersiz bağırsak temizliği oranı okuryazar olmayan hastalarda okuryazar hastalardan daha düşüktü (%21’e karşın %42 ve p=0.05).
Sonuç: Etkili bir kolonoskopi için kolonik mukozanın tamamı dikkatle incelenmelidir. Barsak temizliği dahil işlemin ön hazırlıkları özenle yerine getirilmelidir. Eğitsel videolar kullanılarak hazırlıkların önemini vurgulamak ve bu konuda farkındalığı artırmak faydalı olabilir. Hastaların eğitimi ve rahatı yetersiz olursa kolonoskopi sonuçları tatmin edici olmayabilir.
Anahtar Kelimeler
Bağırsak temizliği çekal entübasyon oranı kolonoskopi; eğitim
Kaynakça
- 1. Johnson DA, Barkun AN, Cohen LB, Dominitz JA, Kaltenbach T, Martel M, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer. Gastroenterology 2014;147:903-24.
- 2. DeSantis CE, Siegel RL, Sauer AG, Miller KD, Fedewa SA, Alcaraz KI, et al. Cancer statistics for African Americans, 2016: Progress and opportunities in reducing racial disparities. CA Cancer J Clin 2016;66:290-308.
- 3. Rizk MK, Sawhney MS, Cohen J, Pike IM, Adler DG, Dominitz JA, et al. Quality indicators common to all GI endoscopic procedures. Gastrointest Endosc 2015;81:3-16.
- 4. Harewood GC, Sharma VK, de Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest Endosc 2003;58:76-9.
- 5. Cohen SM, Wexner SD, Binderow SR, Nogueras JJ, Daniel N, Ehrenpreis ED, et al. Prospective, randomized, endoscopic-blinded trial comparing precolonoscopy bowel cleansing methods. Dis Colon Rectum 1994;37:689-96.
- 6. Ness RM, Manam R, Hoen H, Chalasani N. Predictors of inadequate bowel preparation for colonoscopy. Am J Gastroenterol 2001;96:1797-802.
- 7. Bannert C, Reinhart K, Dunkler D, Trauner M, Renner F, Knoflach P, et al. Sedation in screening colonoscopy: impact on quality indicators and complications. Am J Gastroenterol 2012;107:1837-48.
- 8. Baudet JS, Aguirre-Jaime A. The sedation increases the acceptance of repeat colonoscopies. Eur J Gastroenterol Hepatol 2012;24:775-80.
- 9. Zorzi M, Senore C, Da Re F, Barca A, Bonelli LA, Cannizzaro R, et al. Quality of colonoscopy in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: the EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy). Gut 2015;64:1389-96.
Öz
Objectives: This study aims to investigate if education level has any effect on bowel cleansing.
Materials and methods: We retrospectively evaluated 100 patients (54 males, 46 females; mean age 55±14 years; range, 19 to 83 years) who underwent colonoscopy for any reason in the Endoscopy Unit of Gastroenterology Department of Izmir Tepecik Education and Research Hospital between 01 August 2015 and 30 November 2015. Data were obtained from the computerized system of the hospital. We grouped patients according to age, gender, educational status, being inpatient or outpatient, colon-cleansing and if cecum was accessed or not.
Results: Twenty-nine patients were unschooled and 19 patients were illiterate. Ten of the 19 patients in whom cecal intubation was not achieved were unschooled. Cecal intubation rate (CIR) in outpatients was higher than inpatients (84% vs. 54% and p=0.002). Cecal intubation rate was lower in the illiterate patients than the literate patients (57% vs. 86% and p=0.008). Cecal intubation rate was lower in the unschooled patients than the schooled patients (65% vs. 87% and p=0.01). Cecum was accessed in all patients who were university graduates. Inadequate bowel cleansing rate was lower in the illiterate patients than the literate patients (21% vs. 42% and p=0.05).
Conclusion: All colonic mucosa should be carefully examined for an effective colonoscopy. Bowel cleansing, including preliminary procedure preparations, should be handled with care. It may be beneficial to emphasize the importance of preparations using educational videos and raise awareness in this regard. Colonoscopy results may be unsatisfactory if the training and comfort of patients are inadequate.
Kaynakça
- 1. Johnson DA, Barkun AN, Cohen LB, Dominitz JA, Kaltenbach T, Martel M, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer. Gastroenterology 2014;147:903-24.
- 2. DeSantis CE, Siegel RL, Sauer AG, Miller KD, Fedewa SA, Alcaraz KI, et al. Cancer statistics for African Americans, 2016: Progress and opportunities in reducing racial disparities. CA Cancer J Clin 2016;66:290-308.
- 3. Rizk MK, Sawhney MS, Cohen J, Pike IM, Adler DG, Dominitz JA, et al. Quality indicators common to all GI endoscopic procedures. Gastrointest Endosc 2015;81:3-16.
- 4. Harewood GC, Sharma VK, de Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest Endosc 2003;58:76-9.
- 5. Cohen SM, Wexner SD, Binderow SR, Nogueras JJ, Daniel N, Ehrenpreis ED, et al. Prospective, randomized, endoscopic-blinded trial comparing precolonoscopy bowel cleansing methods. Dis Colon Rectum 1994;37:689-96.
- 6. Ness RM, Manam R, Hoen H, Chalasani N. Predictors of inadequate bowel preparation for colonoscopy. Am J Gastroenterol 2001;96:1797-802.
- 7. Bannert C, Reinhart K, Dunkler D, Trauner M, Renner F, Knoflach P, et al. Sedation in screening colonoscopy: impact on quality indicators and complications. Am J Gastroenterol 2012;107:1837-48.
- 8. Baudet JS, Aguirre-Jaime A. The sedation increases the acceptance of repeat colonoscopies. Eur J Gastroenterol Hepatol 2012;24:775-80.
- 9. Zorzi M, Senore C, Da Re F, Barca A, Bonelli LA, Cannizzaro R, et al. Quality of colonoscopy in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: the EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy). Gut 2015;64:1389-96.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 18 Nisan 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 4 Sayı: 1 |
