Tariq Hassan, Kamal Muhammad Umar, Sapkota Binita, ElShikh Fady, Pirzada Usman Ali, Pullela Nanda, Azam Sara, Zhang Aiyi, Baiomi Ahmed, Abbas Hafsa, Makker Jasbir, Balar Bhavna, Ihimoyan Ariyo, Daniel Myrta, Dev Anil
Department of Medicine, BronxCare Health System, New York City, New York, USA.
Division of Gastroenterology, Department of Medicine, BronxCare Health System, New York City, New York, USA.
BMJ Open Gastroenterol. 2019 Jan 24;6(1):e000254. doi: 10.1136/bmjgast-2018-000254. eCollection 2019.
Colonoscopy is a commonly used modality for screening and surveillance of colorectal cancer (CRC). Therefore, it is essential to have adequate bowel preparation (prep) for the procedure which depends on type of bowel regimens, diet before colonoscopy and timing of the procedure.
The purpose of this study is to analyse the effect of multiple factors on adenoma detection rate (ADR) and prep quality of colonoscopy. This is the also the first study determining outcomes based on various combinations of diet, timing of the procedure and bowel prep regimens.
This is a retrospective single-centre observational study. Data about diet before procedure, bowel prepprep regimen and timing of the procedure was collected for patients coming for screening colonoscopy.
Patients with split prep had higher good prep rates (73.8% vs 56.2%) and higher ADRs (34.2 % vs 29.9%) as compared with non-split prep. The good prep quality (65.8% vs 62.1%) and ADRs (31.9% vs 31.5%) were comparable in patients who received clear liquid diet as compared with low residue diet. The good results of bowel prep were obtained with split prep with either clear liquids or low residue diet irrespective of the timing of procedure. The poor prep was noticed in patients who underwent procedure in afternoon, with a low restrictive diet and non-split bowel regimen.
The current study adds to our knowledge about the combined effect of multiple variables affecting the bowel prep quality and ADR. It is imperative to opt for the best combination required for colonoscopy, as this will influence the effectiveness of colonoscopies regarding timely cancer detection and prevention.
结肠镜检查是用于筛查和监测结直肠癌（CRC）的常用方法。因此，对于该检查而言，进行充分的肠道准备至关重要，这取决于肠道准备方案的类型、结肠镜检查前的饮食以及检查时间。
本研究的目的是分析多种因素对结肠镜检查腺瘤检出率（ADR）和肠道准备质量的影响。这也是第一项基于饮食、检查时间和肠道准备方案的各种组合来确定结果的研究。
这是一项回顾性单中心观察性研究。收集了前来进行筛查结肠镜检查患者的检查前饮食、肠道准备方案和检查时间的数据。
与非分段准备相比，采用分段准备的患者具有更高的良好准备率（73.8%对56.2%）和更高的ADR（34.2%对29.9%）。与低渣饮食相比，接受清流食的患者良好准备质量（65.8%对62.1%）和ADR（31.9%对31.5%）相当。无论检查时间如何，采用清流食或低渣饮食的分段准备均可获得良好的肠道准备效果。在下午进行检查、采用低限制饮食和非分段肠道准备方案的患者中观察到准备不佳。
本研究增加了我们对影响肠道准备质量和ADR的多个变量综合作用的认识。选择结肠镜检查所需的最佳组合至关重要，因为这将影响结肠镜检查在及时癌症检测和预防方面的有效性。
