Covid-19 pandemic impact on colonoscopy service and suggestions for managing recovery

Author:

Cadoni Sergio1,Ishaq Sauid23,Hassan Cesare4,Bhandari Pradeep5,Neumann Helmut6,Kuwai Toshio7,Uedo Noriya8,Parra-Blanco Adolfo9,Mulder Chris J.J.10,Binmoeller Kenneth F.11,Leung Felix W.1213

Affiliation:

1. CTO Hospital, Digestive Endoscopy Unit, Iglesias, Italy

2. Russell Hall, Dept. of Gastroenterology, Birmingham, United Kingdom

3. Birmingham City University, Birmingham, United Kingdom

4. Nuovo Regina Margherita Hospital, Gastroenterology, Italy

5. Portsmouth University Hospital, Dept. of Gastroenterology, Portsmouth, United Kingdom

6. University Medical Center Mainz, Interventional Endoscopy Center, I. Medizinische Klinik und Poliklinik, Mainz, Germany

7. National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Gastroenterology, Kure, Japan

8. Osaka International Cancer Institute, Department of Gastrointestinal Oncology, Osaka, Japan

9. NIHR Nottingham Digestive Diseases Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Gastroenterology, Nottingham, United Kingdom

10. VU University Medical Center, Dept. of Gastroenterology, Arnhem, Netherlands

11. California Pacific Medical Center, California, United States

12. Veteran Affairs Greater Los Angeles Healthcare System, Sepulveda Ambulatory Care Center, California, United States

13. David Geffen School of Medicine at UCLA, Medicine, North Hills, California, United States.

Abstract

Abstract Background and aim As the post-peak phase of the epidemic is approaching, there is an urgent need of an action plan to help resume endoscopy activity. To manage the Covid-19 pandemic-imposed backlog of postponed colonoscopy examinations, an efficient approach is needed. The practice of on-demand sedation with benzodiazepines and/or opiates will allow most patients to complete a water-aided examination with minimal or no sedation. Other methods reported to minimize patient discomfort during colonoscopy can be used, in addition to water-aided techniques. Unsedated or minimally sedated patients who do not require recovery or require a shorter one allow rapid turnaround. The practice obviates the need for assistance with deep sedation from anesthesiologists, who may be in short supply. Trainee education in water-aided colonoscopy has been demonstrated to confer benefits. This review provides some insights into the impact of Covid-19 on endoscopy services, challenges ahead, and possible solutions to help recovery of colonoscopy work and training.

Publisher

Georg Thieme Verlag KG

Subject

Gastroenterology,Medicine (miscellaneous)

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