Complications of colonoscopy in a large public county hospital in Greece. A 10-year study.

BACKGROUND AND STUDY AIMS: Information about the complications of colonoscopy in Southern Europe is limited, particularly in Greece where it is non-existent. Our study sought to determine the complications of colonoscopy in a large public county hospital in Greece over a 10-year period. PATIENTS AND METHODS: All colonoscopy procedures from 1996 to 2006 were entered into a database. Data were analysed by both univariate and multivariate methods. RESULTS: Nine thousand six hundred forty-eight colonoscopies were entered into a database. The procedures were diagnostic in 79% and therapeutic in 21%. Overall bleeding complications occurred in 83 out of the 9648 patients (0.8%: 95% confidence interval [0.7%, 0.9%]). Perforation occurred in four female patients (0.04%: 95% confidence interval [0.01%, 0.07%]) in the sigmoid colon. Multivariate stepwise logistic regression analysis in the therapeutic colonoscopies revealed that presence of significant polyps (odds ratio 4.7, confidence interval [2.9-7.6]), the male sex (odds ratio 2, 95% confidence interval [1.2-3.3]) and the time period of the procedure (the first 5 years) (odds ratio 1.7, 95% confidence interval [1.01-3]), are significant predictors of a post-colonoscopy bleeding episode. CONCLUSION: This historical cohort study, the first in Greece on this subject, shows that colonoscopy is a rather safe procedure and that the rate of complications in this study was low.

Bipolar electrocoagulation vs conventional monopolar hot biopsy forceps in the endoscopic treatment of diminutive rectal adenomas.

OBJECTIVE: To assess whether a cold biopsy from a diminutive rectal adenoma followed by destruction with bipolar (gold probe) electrocoagulation using large probes and high power setting would be a safe and efficient alternative to conventional monopolar hot biopsy forceps (MHBF). PATIENTS AND METHODS: Eligible patients were those undergoing colonoscopy, fulfilling the criteria of additional clearing colonoscopy and having at least one suspected rectal adenoma < or = 5 mm. At the time of endoscopy patients were randomized to receive treatment for their diminutive rectal adenomas either with cold biopsy followed by repeated gold probe electrocoagulation (Group A) using a 10 Fr catheter with setting 8 (40 W) for 1 second or with MHBF (Group B). These patients were followed up with a colonoscopy at 2-4 months. RESULTS: A total number of 24 (15 males, 9 females; mean age 56 years) patients were included in group A and 26 (14 males, 12 females; mean age 58 years) in group B. A total number of 38 and 37 diminutive rectal adenomas was detected in patients of Group A and Group B, respectively. At follow up colonoscopy residual adenoma tissue was found in 2 (5.2%) adenomas of 38 in Group A and in 4 (10.8%) of 37 in Group B (P > 0.3). No complications related to colonoscopy or endoscopic treatments in both groups occurred. CONCLUSIONS: Our data suggest that the use of cold biopsy followed by bipolar electrocoagulation using large probes and high power setting for destroying diminutive rectal adenoma seems to be equally effective and safe as MHBF.