Fluoroscopy in colonoscopy. who is using it and why?
Rauh, S.M.; Coller, J.A.; Schoetz, D.J.
American Surgeon 55(11): 669-674
1989
ISSN/ISBN: 0003-1348 PMID: 2817621 Document Number: 331572
Use of fluoroscopy during colonoscopy has never been broadly assessed. A survey of 1,864 members of the Society of American Gastrointestinal Endoscopic Surgeons and the American Society of Colon and Rectal Surgeons was carried out to quantify the use of fluoroscopy and to elicit impressions regarding its capabilities, indications, and usefulness. After the establishment of the responding colonoscopist's training, experience, and other background data, impressions of fluoroscopy's role in many issues were obtained using a graded response system. Concluding the two-page survey were open-ended questions addressing the respondent's indications, contraindications, and rationale for using or not using fluoroscopy. Six hundred thirty-one colonoscopists responded. Seventy-five per cent never use fluoroscopy; the most frequently cited reasons were lack of need and inaccessibility of fluoroscopy. For many colonoscopists, fluoroscopy is unavailable (22%) or available outside of the usual endoscopy setting (44%). Fluoroscopy is used by 25 per cent of colonoscopists. Almost three quarters of this group have the capability of performing fluoroscopy in their colonoscopy unit. The indications for fluoroscopy varied with the frequency of its use; frequent users employ fluoroscopy to treat loops, to confirm cecal intubation, and to locate the instrument tip precisely. Infrequent users employ fluoroscopy to apply the sigmoid straightening overtube or because of prior failed colonoscopy. Impressions regarding the impact of fluoroscopy on learning, completing, and safeguarding colonoscopy were obtained. Most colonoscopists are satisfied without using fluoroscopy, although 65 per cent of nonusers believe it would improve colonoscopy performance if it were used. Ninety-two per cent of frequent users of fluoroscopy reported that they would feel significantly impaired without having the capability to perform fluoroscopy.