Qualitymonitoringincolonoscopy:Timetoact

摘要： Colonoscopyisthegoldstandardtestforcolorectalcancerscreening.Theprimaryadvantageofcolonoscopyasopposedtootherscreeningmodalitiesistheabilitytoprovidetherapybyremovalofprecancerouslesionsatthetimeofdetection.However,colonoscopymaymissclinicallyimportantneoplasticpolyps.Thevalueofcolonoscopyinreducingincidenceofcolorectalcancerisdependentonmanyfactorsincluding,thepatient,provider,andfacilitylevel.Ahighqualityexaminationincludesadequatebowelpreparation,optimalcolonoscopytechnique,meticulousinspectionduringwithdrawal,identificationofsubtleflatlesions,andcompletepolypectomy.Considerablevariationamonginstitutionsandendoscopistshasbeenreportedintheliterature.Inattempttodiminishthisdisparity,variousapproacheshavebeenadvocatedtoimprovethequalityofcolonoscopy.Theoverallimpactoftheseinterventionsisnotyetwelldefined.Implementingoptimaleducationandtrainingandsubsequentlyanalyzingtheimpactoftheseendeavorsinimprovementofqualitywillbeessentialtoaugmenttheutilityofcolonoscopyforthepreventionofcolorectalcancer. （共8页）