Reviewer's report
Title:What are the risk factors of colonoscopic perforation?
Version: 2Date:13 June 2009
Reviewer: Anthony Teoh
Reviewer's report:
Major Compulsory Revisions
Results section
- A no. of other risk factors for analysis could be included for analysis: Previous
operations, pelvic operations, pelvic inflammatory diseases, pelvic radiotherapy,
diverticular disease, sigmoid volvulus, peritoneal dialysis, pseudoobstruction,
presence of intra-abdominal adhesions, presence of colonic malignancy and
co-morbidities
Discussion
- It is a bit alarming that the overall perforation rate has increased significantly in
this study as compared to your last review. How does the outcomes of this study
compare to your last study? Any potential contributing factors to increased
perforations? Can you discuss in the discussion section
Minor Essential Revisions
Methods section
- What is the definition of emergency endoscopy? Do you give bowel prep to
these patients?
- For the sedation group, only propofol and fentanyl was used. Did any patients
received other sedatives e.g. benzodiazepams. Do you think that the choice of
drugs for sedation affects the endoscopist’s perception of pain experienced by
the patient?
- Further, was propofol during your last review from 1999 to 2007? Do you think
this could possible have affected the overall perforation rates?
- 2L of PEG as bowel preparation may not be adequate in some patient. Was
there documentation of the quality of bowel prep? Is this different between the
perforated and non-perforated groups?
Results section
- 6/15 perforations due to trainees that is quite a high percentage, is there any
explanation? Your no. in colonoscopies seems to have grown throughout the
pass few yrs. Are more colonoscopies being performed by trainees?
- What is the proportion of perforations that are sustained from diagnostics and
therapeutic colonoscopies. Is the difference significant?
- Some suggestions to table 1, the endoscopic procedure should be grouped into
whether it is diagnostic or therapeutic and the possible mechanism of perforation
is probably better grouped according to whether it is mechanical or due to a
procedure (hot/cold biopsy, polypectomy).
- What are the P values and odds ratio of the factors on multivariate analysis, pls
list out in table
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I have no disclosures to make.
Reviewer's report
Title:What are the risk factors of colonoscopic perforation?
Version: 2Date:13 June 2009
Reviewer: Anthony Teoh
Reviewer's report:
Major Compulsory Revisions
Results section
- A no. of other risk factors for analysis could be included for analysis: Previous
operations, pelvic operations, pelvic inflammatory diseases, pelvic radiotherapy,
diverticular disease, sigmoid volvulus, peritoneal dialysis, pseudoobstruction,
presence of intra-abdominal adhesions, presence of colonic malignancy and
co-morbidities
Discussion
- It is a bit alarming that the overall perforation rate has increased significantly in
this study as compared to your last review. How does the outcomes of this study
compare to your last study? Any potential contributing factors to increased
perforations? Can you discuss in the discussion section
Minor Essential Revisions
Methods section
- What is the definition of emergency endoscopy? Do you give bowel prep to
these patients?
- For the sedation group, only propofol and fentanyl was used. Did any patients
received other sedatives e.g. benzodiazepams. Do you think that the choice of
drugs for sedation affects the endoscopist’s perception of pain experienced by
the patient?
- Further, was propofol during your last review from 1999 to 2007? Do you think
this could possible have affected the overall perforation rates?
- 2L of PEG as bowel preparation may not be adequate in some patient. Was
there documentation of the quality of bowel prep? Is this different between the
perforated and non-perforated groups?
Results section
- 6/15 perforations due to trainees that is quite a high percentage, is there any
explanation? Your no. in colonoscopies seems to have grown throughout the
pass few yrs. Are more colonoscopies being performed by trainees?
- What is the proportion of perforations that are sustained from diagnostics and
therapeutic colonoscopies. Is the difference significant?
- Some suggestions to table 1, the endoscopic procedure should be grouped into
whether it is diagnostic or therapeutic and the possible mechanism of perforation
is probably better grouped according to whether it is mechanical or due to a
procedure (hot/cold biopsy, polypectomy).
- What are the P values and odds ratio of the factors on multivariate analysis, pls
list out in table
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I have no disclosures to make.
Please review this paper.
user
Reviewer's report
Title:What are the risk factors of colonoscopic perforation?
Version: 2Date:13 June 2009
Reviewer: Anthony Teoh
Reviewer's report:
Major Compulsory Revisions
Results section
- A no. of other risk factors for analysis could be included for analysis: Previous
operations, pelvic operations, pelvic inflammatory diseases, pelvic radiotherapy,
diverticular disease, sigmoid volvulus, peritoneal dialysis, pseudoobstruction,
presence of intra-abdominal adhesions, presence of colonic malignancy and
co-morbidities
Discussion
- It is a bit alarming that the overall perforation rate has increased significantly in
this study as compared to your last review. How does the outcomes of this study
compare to your last study? Any potential contributing factors to increased
perforations? Can you discuss in the discussion section
Minor Essential Revisions
Methods section
- What is the definition of emergency endoscopy? Do you give bowel prep to
these patients?
- For the sedation group, only propofol and fentanyl was used. Did any patients
received other sedatives e.g. benzodiazepams. Do you think that the choice of
drugs for sedation affects the endoscopist’s perception of pain experienced by
the patient?
- Further, was propofol during your last review from 1999 to 2007? Do you think
this could possible have affected the overall perforation rates?
- 2L of PEG as bowel preparation may not be adequate in some patient. Was
there documentation of the quality of bowel prep? Is this different between the
perforated and non-perforated groups?
Results section
- 6/15 perforations due to trainees that is quite a high percentage, is there any
explanation? Your no. in colonoscopies seems to have grown throughout the
pass few yrs. Are more colonoscopies being performed by trainees?
- What is the proportion of perforations that are sustained from diagnostics and
therapeutic colonoscopies. Is the difference significant?
- Some suggestions to table 1, the endoscopic procedure should be grouped into
whether it is diagnostic or therapeutic and the possible mechanism of perforation
is probably better grouped according to whether it is mechanical or due to a
procedure (hot/cold biopsy, polypectomy).
- What are the P values and odds ratio of the factors on multivariate analysis, pls
list out in table
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I have no disclosures to make.
assistant