title: [Does endoscopist fatigue play a role in incomplete colonoscopies and detection of polypoid lesions?].
abstract: BACKGROUND
  Nowadays, the possible effect of endoscopist fatigue on the results of colonoscopies is under discussion. We aimed to analyze possible differences in cecal intubation and the polyp and adenoma detection rate, depending on whether colonoscopies were performed at the beginning or at the end of the daily endoscopy session and to analyze the influence of the queue position on the detection rate.
  
  
  METHODS
  A retrospective study was performed with 1,000 ambulatory and consecutive colonoscopies, divided into 2 groups: «early» and «late» procedures. A total of 95 colonoscopies were excluded due to poor colon cleansing. After confirming that patient characteristics were homogenous in the two groups, we compared the frequency of complete colonoscopies and the polyp and adenoma detection rate. Possible differences between the 2 groups in the polyp detection rate according to the colonoscopy schedule were analyzed.
  
  
  RESULTS
  The overall polyp and adenoma detection rates were 44.2 and 30.5%, respectively, with no significant differences among 13 different endoscopists; polyps: p = 0.21; adenomas: p=0.63. No significant differences were found between the «early group» (n= 532) and the «late group» (n = 373) in the rates of complete colonoscopies [97.2 vs 99.4% (p=0.92)], the polyp detection rate [45.9 vs 41.8% (p=0.23)], the adenoma detection rate [30.8 vs 30% (p=0.80)] or the serrated adenoma rate [2.1% vs 1.6% (p=0.62)]. The lesion detection rate did not vary in relation to the «queue position»: polyps [p = 0.60, and adenomas: p = 0.83.
  
  
  CONCLUSIONS
  In our series, endoscopist fatigue at the end of the day had no influence on the complete colonoscopy rate or on the polyp and adenoma detection rate. There were no differences in the number of polypoid lesions detected according to the timing of the colonoscopy schedule.
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Pamplona, España. Electronic address: bordafernando@yahoo.es.
authors.forename: Fernando
authors.initials: F
authors.lastname: Borda
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Borda
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Jiménez
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Fernández-Urién
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Vila
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Zozaya
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D002400:Cathartics; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003111:Colonic Polyps / Q000175:diagnosis* / Q000453:epidemiology; D003113:Colonoscopy / Q000523:psychology*; D003951:Diagnostic Errors; D005221:Fatigue / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000453:epidemiology; D009784:Occupational Diseases / Q000209:etiology / Q000523:psychology*; D012189:Retrospective Studies; D016526:Workload
chemical_list: D002400:Cathartics
keywords: Adenomas/diagnosis; Adenomas/diagnóstico; Carga de trabajo; Colonoscopia; Colonoscopy; Colorectal polyps/diagnosis; Fatiga; Fatigue; Horario de trabajo; Pólipos colorrectales/diagnóstico; Schedule timing; Workload