AB192. 182. PR exam in colonoscopy—what are we missing?

Background: The British Society for Gastroenterology and the Joint Advisory Group on GI endoscopy in their 2016 recommendations, have highlighted that per rectum (PR) examination should be documented in 100% of colonoscopies. The primary aim of this study was to examine PR documentation in colonoscopy reports at this institution.

Methods: A retrospective study was conducted using the electronic endoscopy database, Endoraads. Colonoscopy reports were examined over a 6-month period to ascertain PR documentation rates. Data was collated in an encrypted database and exported to SPSS for statistical analysis.

Results: Five hundred and fifty-five colonoscopies were included for analysis over a 6-month period in 2017. The male to female ratio was 266:289. PR exam was documented in only 42% of colonoscopies. Gender and operator reported caecal intubation rates played no role in PR documentation, however there was a statistical significant likelihood of better photographic documentation of the caecum when PR exam was documented (P<0.001). There was also a higher polyp detection rate when PR exam was documented (P=0.046).

Conclusions: As demonstrated, PR documentation at this institution is falling below recommended targets. One possible reason for this is the lack of a dedicated reporting box on the Endoraads reporting tool. These authors plan to hold educational sessions with all endoscopists in our unit to improve the documentation of PR examination. Additionally, these authors intend to liaise with Endoraads to add a specific section for reporting on PR examination.

Keywords: Per rectum (PR); examination; rates