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LETTERS TO THE EDITOR
Year : 2017  |  Volume : 16  |  Issue : 1  |  Page : 35  

Comments on: Colonoscopy at a tertiary health-care facility in Southwest Nigeria – spectrum of indications and colonic abnormalities


Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia

Date of Web Publication14-Mar-2017

Correspondence Address:
Mahir Gachabayov
Stavrovskaya Street, 6-73, Vladimir 600022
Russia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aam.aam_38_16

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How to cite this article:
Gachabayov M. Comments on: Colonoscopy at a tertiary health-care facility in Southwest Nigeria – spectrum of indications and colonic abnormalities. Ann Afr Med 2017;16:35

How to cite this URL:
Gachabayov M. Comments on: Colonoscopy at a tertiary health-care facility in Southwest Nigeria – spectrum of indications and colonic abnormalities. Ann Afr Med [serial online] 2017 [cited 2017 Aug 23];16:35. Available from: http://www.annalsafrmed.org/text.asp?2017/16/1/35/202085



Sir,

I have read the paper by Akere et al. regarding 250 colonoscopy cases at a tertiary hospital with great interest.[1] I would like to extend my thanks to the authors for nice analysis and graphically illustrated data. However, I have several comments on this paper.


   First Comment Top


In this patient series, the authors showed the diagnostic yield to be 74%; abnormalities were detected in 185 patients which is graphically illustrated in [Figure 1]. However, later while analyzing the number of abnormalities, the authors stated that one abnormality was detected in 203 patients (81.2%), two abnormalities in 44, and three abnormalities in 3 patients (nicely demonstrated in the histogram in [Figure 2]). In this case, it turns out that all 250 patients had at least one abnormality. Of course, this could be a mechanical error. Anyway, this is subject to correction.{Figure 1}{Figure 2}


   Second Comment Top


The authors stated that the indication in 85 patients (34%) was hematochezia, which is graphically illustrated in [Table 2]. However, later while analyzing those patients with hematochezia, the total number of patients with this condition turns out to be at least 102 (“hemorrhoids in 36 [31%], diverticulosis in 34 [29.3%], colorectal tumor in 16 [13.8%], and colonic polyps also in 16 [13.8%] patients”). Of course, one could imagine that there were some patients with more than one finding. However, the pie chart in [Figure 3] clearly illustrates that all these patients with hematochezia had only one detected abnormality. This could also be a mechanical mistake. However, I believe such discrepancies should have been avoided.{Table 2}{Figure 3}


   Third Comment Top


There are also some unclear issues which, I believe, are also very important for surgeons, gastroenterologists, endoscopists, and other specialists. Surely, it would be very nice to mention the colonoscopy completion rate (cecal intubation) in this series because from previous studies we know the completion rate to be at about 83% in symptomatic patients [2] and up to 95% for elective colonoscopy.[3] Another question is whether or not there were any complications (either early or late).

To conclude, the paper is an interesting study, at least for surgeons, gastroenterologists, and endoscopists. It would be nice of authors to clarify the addressed issues.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Akere A, Oke TO, Otegbayo JA. Colonoscopy at a tertiary healthcare facility in Southwest Nigeria: Spectrum of indications and colonic abnormalities. Ann Afr Med 2016;15:109-13.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Loffeld RJ, van der Putten AB. The completion rate of colonoscopy in normal daily practice: Factors associated with failure. Digestion 2009;80:267-70.  Back to cited text no. 2
    
3.
Nelson DB, McQuaid KR, Bond JH, Lieberman DA, Weiss DG, Johnston TK. Procedural success and complications of large-scale screening colonoscopy. Gastrointest Endosc 2002;55:307-14.  Back to cited text no. 3
    




 

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