Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, 39F Gangnam Finance Center 152, Teheran-ro, Gangnam-gu, Seoul, 06236, South Korea.
Dig Dis Sci. 2021 Apr;66(4):1168-1174. doi: 10.1007/s10620-020-06321-3. Epub 2020 May 18.
Adequate bowel preparation is crucial for effective screening colonoscopy. However, it is unclear whether higher bowel preparation scores correspond to beneficial effects on the adenoma and polyp detection rate (ADR and PDR) in the adequate bowel preparation group.
This study aimed to evaluate the effects of bowel preparation, according to the Boston Bowel Preparation Scale (BBPS), and colonoscopy withdrawal time (CWT) on ADR and PDR in the adequate bowel preparation group.
Healthy examinees between 50 and 75 years old who underwent colonoscopy between September 2015 and August 2016 were included. BBPS scores, CWT, ADR, and PDR were reviewed retrospectively. Predictors of ADR and PDR were analyzed with a generalized linear mixed model.
A total of 5073 cases with adequate bowel preparation (BBPS ≥ 6) were analyzed. Examinees with good (BBPS = 6, 7) and excellent (BBPS = 8, 9) bowel preparation were 1898 (37.4%) and 3175 (62.6%), respectively. Both ADR and PDR were higher in the good bowel preparation group than in the excellent bowel preparation group (ADR 47.3% vs. 45.0%, P = 0.035; PDR 73.7% vs. 69.5%, P = 0.004, respectively). In the multivariate analysis, CWT, rather than BBPS, was significantly associated with both ADR (OR 1.04; 95% CI 1.02-1.06; P < 0.001) and PDR (OR 1.05; 95% CI 1.02-1.07; P = 0.002).
Both ADR and PDR were lower when bowel preparation was excellent rather than good. However, CWT, not BBPS, was significantly associated with ADR and PDR in the adequate bowel preparation group. Therefore, meticulous inspection is important for high-quality colonoscopy regardless of the BBPS score in examinees with adequate bowel preparation.
充分的肠道准备对于有效的筛查性结肠镜检查至关重要。然而，在肠道准备充分的患者中，较高的肠道准备评分是否与腺瘤和息肉检出率（ADR 和 PDR）的有益效果相关，目前尚不清楚。
本研究旨在评估波士顿肠道准备评分（BBPS）和结肠镜退镜时间（CWT）对肠道准备充分患者的 ADR 和 PDR 的影响。
回顾性分析 2015 年 9 月至 2016 年 8 月间接受结肠镜检查的 50-75 岁健康受检者的临床资料。分析 BBPS 评分、CWT、ADR 和 PDR。采用广义线性混合模型分析 ADR 和 PDR 的预测因素。
共分析了 5073 例肠道准备充分（BBPS≥6）的患者。BBPS 评分为 6、7 的患者分别为 1898 例（37.4%）和 3175 例（62.6%）。良好肠道准备组的 ADR 和 PDR 均高于优秀肠道准备组（ADR 47.3%比 45.0%，P=0.035；PDR 73.7%比 69.5%，P=0.004）。多因素分析显示，CWT 与 ADR（OR 1.04；95%CI 1.02-1.06；P<0.001）和 PDR（OR 1.05；95%CI 1.02-1.07；P=0.002）均显著相关，而 BBPS 与 ADR 和 PDR 均无显著相关性。
与肠道准备良好相比，肠道准备优秀时 ADR 和 PDR 较低。然而，在肠道准备充分的患者中，CWT 与 ADR 和 PDR 显著相关，而不是 BBPS。因此，无论肠道准备的 BBPS 评分如何，细致的检查对于高质量的结肠镜检查都很重要。
