Suboptimal Bowel Preparation Significantly Impairs Colonoscopic Detection of Non-polypoid Colorectal Neoplasms

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• 作者：Chi Hyuk Oh ; Chang Kyun Lee ; Jung-Wook Kim ; Jae-Jun Shim…
• 关键词：Bowel preparation ; Colonoscopy ; Colonic polyps ; Non ; polypoid colorectal neoplasm ; Adenoma detection rate
• 刊名：Digestive Diseases and Sciences
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：60
• 期：8
• 页码：2294-2303
• 全文大小：404 KB
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• 作者单位：Chi Hyuk Oh (1)
  Chang Kyun Lee (1)
  Jung-Wook Kim (1)
  Jae-Jun Shim (1)
  Jae Young Jang (1)
  
  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyung Hee University School of Medicine, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-701, Korea
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gastroenterology
  Hepatology
  Oncology
  Transplant Surgery
  Biochemistry
  
• 出版者：Springer Netherlands
• ISSN：1573-2568

文摘

Background It is unclear whether the quality of bowel preparation affects colonoscopic detection of non-polypoid colorectal neoplasms (NP-CRNs). Aim To evaluate the impact of bowel-cleansing quality on detection of NP-CRNs. Methods We performed a retrospective analysis of asymptomatic screening colonoscopy cases after standardized bowel preparation at an academic teaching hospital between June 2011 and May 2013. Primary outcome was a comparison of the adenoma detection rate (ADR) of non-polypoid morphology according to quality of bowel preparation. Secondary outcomes included detection prevalence of non-polypoid adenomas. Results Of the enrolled 6097 screening examinations, the preparation quality was rated as adequate (excellent or good) in 5224 (85.7?%), fair in 615 (10.1?%), and poor in 258 (4.2?%) patients. The prevalence of NP-CRNs was 40.5?% (1962/4847) of all CRNs. The overall ADR of non-polypoid morphology was 12.3?% (747/6097) of all colonoscopies, but it significantly differed among participating endoscopists (all P?<?0.05). The ADR of non-polypoid morphology was significantly lower with fair- or poor-quality preparation, versus adequate-quality preparation (adjusted odds ratio [aOR] 0.55, 95?% confidence interval [CI] 0.41-.75; aOR 0.49, 95?% CI 0.30-.79, respectively). Poor-quality preparation was also associated with impaired detection of polypoid, proximal colon, and sub-centimeter adenomas (all P?<?0.05). Conclusions Suboptimal (fair or poor) bowel preparation significantly impairs colonoscopic detection of NP-CRNs. Given that the prevalence of NP-CRNs is substantial in our average-risk screening cohort, ongoing efforts to improve the preparation quality are practically valuable in increasing the detection of NP-CRNs, thereby improving the efficacy of screening colonoscopies.