Appropriateness of Indication and Diagnostic Yield of Colonoscopy in a Teaching Hospital in the Republic of Congo

Objectives: The aim of our work was to assess the appropriateness of colonoscopy indications according to the 2000 ASGE recommendations and their diagnostic yield at the Brazzaville University Hospital. Methods: This was a retrospective study. Patients over 18 years of age who underwent colonoscopy at the Brazzaville University Hospital from January 2021 to December 2022 were included. Data was extracted from colonoscopy reports and patients’ medical records. That included demographic data, indications and examination results. Diagnostic yield was also determined for each indication. Results: Among the 156 patients studied, there were 80 men (51.3%) and 76 women (48.7%). Mean age was 56.2 +/− 15.4 years. Eighty-two (52.6%) had undergone colonoscopy for indications considered as appropriate or reasons generally indicated. Those who had undergone the examination for reasons not generally indicated according to ASGE guidelines and those whose indications were not listed in these recommendations were 21.8% and 25.6% respectively. Among significant findings, malignant lesions and chronic inflammatory bowel disease were found in 11 (7.1%) and 12 (7.7%) patients respectively. Diagnostic yield was associated with appropriate indications (Odds ratio: 6.39; CI: 2.25 - 18.15). Conclusion: Appropriate indications according to ASGE guidelines had a better diagnostic yield than those that were not. However, significant results were also found for indications not listed in the recommendations, hence the importance of involving clinical reasoning in the decision to undergo colonoscopy.