Division of Gastroenterology and Hepatology.
Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA.
Curr Opin Gastroenterol. 2019 Jan;35(1):51-57. doi: 10.1097/MOG.0000000000000494.
Colonoscopy is recognizably, the best colon cancer prevention test, provided the quality of the preparation is adequate for detection of precancerous polyps but also allowing for accurate identification of margins, thereby facilitating complete endoscopic resection. As there are many aspects effecting colon prep outcomes, it is timely to review new standards for optimizing outcomes, including product selection based on patient demographics.
New national guidelines have set a minimum quality threshold for adequacy and also defined a split day delivery for oral options as the "standard of care". Several new prep options have been recently released and these data are discussed.
Optimizing the quality of colon preps has major implications for clinical practice. Clinicians must recognize new targets for standard of care, providing the best approach for each individual patient, considering variable factors which may otherwise compromise success.
结肠镜检查是公认的预防结肠癌的最佳检测方法,前提是肠道准备的质量足以检测到癌前息肉,并且还能够准确识别边缘,从而便于进行完整的内镜切除。由于影响肠道准备效果的因素很多,因此及时审查新的优化结果标准非常重要,包括根据患者人口统计学特征选择产品。
新的国家指南为充分性设定了最低质量阈值,并将口服药物的分日给药定义为“标准护理”。最近推出了几种新的准备选择,本文讨论了这些数据。
优化肠道准备的质量对临床实践具有重要意义。临床医生必须认识到标准护理的新目标,为每个患者提供最佳方法,同时考虑可能影响成功的可变因素。