Mandolesi Daniele, Frazzoni Leonardo, Bazzoli Franco, Fuccio Lorenzo
a Gastroenterology Unit, Department of Medical and Surgical Sciences , University of Bologna, S.Orsola-Malpighi Hospital , Bologna , Italy.
Expert Rev Gastroenterol Hepatol. 2017 Aug;11(8):731-740. doi: 10.1080/17474124.2017.1338947. Epub 2017 Jun 14.
Effective bowel cleansing is crucial for high quality colonoscopy. A notable portion of patients still present with low quality bowel preparation prior to their colonoscopy, compromising the overall quality of their colonoscopy. Areas covered: This review focuses on the main strategies that can improve the cleansing quality with a special interest on those clinical conditions that have been associated with a poor bowel preparation quality, such as patients with chronic constipation, history of bowel resection, liver cirrhosis, diabetes mellitus and chronic kidney disease. The review provides a practical and evidence-based approach to help clinicians in the management of 'hard-to-prepare' patients. Expert commentary: In the past few years, the quality of colonoscopy has become a hot topic and bowel cleansing is a crucial part of it; however, the approach to patients with an increased risk of poor bowel preparation quality is still not always supported by high-quality evidence, since most of these patients are routinely excluded from the clinical studies. Trials focused on this subgroup of patients are recommended to provide tailored bowel preparation regimens and guarantee high-quality procedures.
有效的肠道清洁对于高质量的结肠镜检查至关重要。仍有相当一部分患者在结肠镜检查前肠道准备质量较差，这会影响结肠镜检查的整体质量。涵盖领域：本综述重点关注可提高清洁质量的主要策略，特别关注那些与肠道准备质量差相关的临床情况，如慢性便秘患者、肠道切除史患者、肝硬化患者、糖尿病患者和慢性肾脏病患者。该综述提供了一种实用且基于证据的方法，以帮助临床医生管理“难以准备”的患者。专家评论：在过去几年中，结肠镜检查质量已成为一个热门话题，而肠道清洁是其中的关键部分；然而，对于肠道准备质量差风险增加的患者的处理方法，仍并非总是有高质量证据支持，因为这些患者中的大多数通常被排除在临床研究之外。建议开展针对这一亚组患者的试验，以提供量身定制的肠道准备方案并确保高质量的检查程序。
