title: Increased utilization of flexible endoscopic methods during colorectal resection over a 3-year period.
abstract: BACKGROUND
  Intraoperative endoscopy (IE) is performed during some colorectal resections (CRR) mainly to inspect circular stapled anastomoses (CSA) and to locate small neoplasms. This study's purpose was to determine how often rigid and flexible lower endoscopic methods were used during CRR by one colorectal surgeon over three 1-year periods.
  
  
  METHODS
  Data concerning the indication for surgery and IE, type of resection, and the use of rigid and flexible methods were obtained from a prospective database and from hospital charts during Period 1 (P1), 1/1/05 to 12/31/05; P2, 7/1/06 to 6/31/07; and P3, 7/01/07 to 6/30/08. The endoscopic CO2 insufflation device was introduced during P2. The utilization rates (UR) for rigid and flexible methods and the overall UR in each time period were compared. The chi(2) and Fisher exact test were used for analysis.
  
  
  RESULTS
  No significant differences were found in overall endoscopy UR between periods (94-109/per period.) A significantly higher flexible UR was noted during P3 (43.1% of all CRR) than during P1 (18.6%, P < .001) or P2 (28.7%, P < .03). There was a concomitant significant drop in the rigid UR during Period 3 (1.8% of all CRR) when compared with P1 (24.5%, P < .001) or P2 (27.7%, P < .001).
  
  
  CONCLUSIONS
  The overall UR did not significantly vary; however, during P3 the flexible UR increased whereas the rigid UR decreased (vs P1, P2; P < .05). The addition of extra endoscopes and an endoscopic CO2 insufflation device to the operating room coincided with increased flexible UR.
authors.affiliation: St. Lukes-Roosevelt Hospital Center, New York, NY 10019, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: DiMaggio
authors.forename: Keith
authors.initials: K
authors.lastname: Hoffman
authors.forename: Ray
authors.initials: R
authors.lastname: Baxter
authors.forename: Vesna
authors.initials: V
authors.lastname: Cekic
authors.forename: Abu
authors.initials: A
authors.lastname: Nasar
authors.forename: Richard L
authors.initials: RL
authors.lastname: Whelan
mesh_terms: D020685:Colonoscopes / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D013997:Time Factors