Colonoscopy performed by a family physician. A case series of 751 procedures.

Abstract

BACKGROUND:

Colonoscopy, including biopsy and polypectomy, is a procedure not commonly performed by primary care physicians. The purpose of this research was to present a large case series of colonoscopic procedures performed by a family physician in a rural practice.

METHODS:

A chart review of every colonoscopy procedure performed by a family physician over a 7-year period determined the demographic characteristics, indications, findings, and complications for each procedure.

RESULTS:

A total of 751 colonoscopies were performed on 555 patients (347 women and 208 men), with a mean age of 53.8 years. In 91.5% of procedures, the cecum was intubated. The most common indications for colonoscopy were bleeding (49.9%), polyp follow-up (20.9%) abdominal pain (11.7%), diarrhea (11.6%), and abnormal findings on flexible sigmoidoscopy (8.4%). Three hundred sixteen benign polyps were discovered and removed by either biopsy or polypectomy. There were 184 adenomatous colorectal polyps found in 134 (17.8%) colonoscopies. Of these 184 adenomatous polyps, 106 (58%) were potentially within reach of the flexible sigmoidoscope. Only three adenocarcinomas were discovered during the entire study period. There was only one major procedural complication: a patient experienced blood oozing from a polypectomy stump; cautery stopped the bleeding, and the patient was hospitalized overnight, with no further intervention or transfusion required. There were five other self-limited complications, including adverse reactions to sedation and infiltration at the intravenous site.

CONCLUSIONS:

Colonoscopy with polypectomy that was safely and competently performed in a solo rural practice adds to the evidence that experienced family physicians can provide this important service to their community.

• Authors: R P Pierzchajlo, R J Ackermann, R L Vogel
• Journal: The Journal of family practice (J Fam Pract) Vol. 44 Issue 5 Pg. 473-80 (May 1997) ISSN: 0094-3509 [Print] United States
• PMID: 9152265 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adenocarcinoma (diagnosis, epidemiology)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Colonic Neoplasms (diagnosis, epidemiology)
• Colonic Polyps (diagnosis, surgery)
• Colonoscopy (adverse effects, standards, statistics & numerical data)
• Family Practice (standards, statistics & numerical data)
• Female
• Georgia (epidemiology)
• Humans
• Male
• Middle Aged
• Physicians, Family (education, standards)
• Private Practice
• Retrospective Studies
• Rural Health