Various aspects of quality and safety of colonoscopy

This thesis investigated clinical relevant aspects of quality and safety of colonoscopy. Post-colonoscopy complications such as perforations, bleeding and mortality were analyzed. In the past two decades, more advanced and difficult polyps were resected during colonoscopy, for which previously surgery was performed. Despite this, post-colonoscopy complications rates did not increase, but remained stable. Due to the death of two patients post-colonoscopy due to low potassium levels after bowel cleansing for colonoscopy, the risk on low potassium levels after was investigated in a high risk group. Since this appeared to be a real risk (23.6%), potassium levels before and after bowel cleansing were investigated in the total colonoscopy population. After bowel cleansing for colonoscopy 5.4% of the patients developed low potassium levels. Besides safety aspects, also a specific type of bowel cancer (neuroendocrine tumors) was investigated as well as how an app could help to improve bowel cleansing for colonoscopy