Servicio de Gastroenterología, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN), Departamento de Medicina Interna, Universidad de La Laguna, Tenerife, Spain.
Servicio de Endocrinología y Nutrición, Hospital San Juan de Dios. Santa Cruz de Tenerife, Spain.
Endoscopy. 2019 Jul;51(7):628-636. doi: 10.1055/a-0864-1942. Epub 2019 Apr 3.
The aim of this study was to assess whether a 3-day low-residue diet (LRD) improved bowel cleansing quality compared with a 1-day LRD regimen.
Consecutive patients scheduled for outpatient colonoscopy were randomized to the 1-day LRD or 3-day LRD groups. All patients received a 2-L split-dose of polyethylene glycol plus ascorbic acid. The primary outcome was bowel cleansing quality as evaluated using the Boston Bowel Preparation Scale (BBPS) (adequate cleansing ≥ 2 points per segment). Secondary outcomes were adherence to and level of satisfaction with the LRD, difficulty following the dietary recommendations, and willingness to repeat the same LRD in the future. Intention-to-treat (ITT) and per-protocol (PP) analyses were conducted for the primary outcome. A superiority analysis was performed to demonstrate that a 3-day LRD regimen was superior to a 1-day LRD regimen with a margin of 10 %.
390 patients (1-day LRD group = 196, 3-day LRD = 194) were included. The cleansing quality was not significantly different between the groups: ITT analysis 82.7 % (95 % confidence interval [CI] 77.4 to 88.0) vs. 85.6 % (95 %CI 80.7 to 90.5), with odds ratio (OR) 1.2 (95 %CI 0.72 to 2.15); PP analysis 85.0 % (95 %CI 79.9 to 90.1) vs. 88.6 % (95 %CI 84.0 to 93.2), with OR 1.4 (95 %CI 0.88 to 2.52). No differences were found regarding adherence to the diet or cleansing solution, satisfaction or difficulty with the LRD, and the polyp/adenoma detection rates.
3-day LRD did not offer advantages over 1-day LRD in preparation for colonoscopy.
本研究旨在评估 3 天低渣饮食（LRD）与 1 天 LRD 方案相比是否能改善肠道清洁质量。
连续选择行门诊结肠镜检查的患者被随机分配至 1 天 LRD 组或 3 天 LRD 组。所有患者均接受 2 升 PEG 加维生素 C 分剂量服用。主要结局是采用波士顿肠道准备量表（BBPS）（每段评分≥2 分为肠道清洁充分）评估肠道清洁质量。次要结局是 LRD 的依从性和满意度、遵循饮食建议的难度以及未来重复相同 LRD 的意愿。对主要结局进行意向治疗（ITT）和方案符合（PP）分析。进行了优势分析，以证明 3 天 LRD 方案优于 1 天 LRD 方案，优势幅度为 10%。
共纳入 390 例患者（1 天 LRD 组 196 例，3 天 LRD 组 194 例）。两组肠道清洁质量无显著差异：ITT 分析 82.7%（95%CI 77.4 至 88.0）与 85.6%（95%CI 80.7 至 90.5），优势比（OR）为 1.2（95%CI 0.72 至 2.15）；PP 分析 85.0%（95%CI 79.9 至 90.1）与 88.6%（95%CI 84.0 至 93.2），OR 为 1.4（95%CI 0.88 至 2.52）。在饮食或清洁溶液的依从性、对 LRD 的满意度或困难程度以及息肉/腺瘤检出率方面均未发现差异。
3 天 LRD 方案在结肠镜检查准备方面并未优于 1 天 LRD 方案。
