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, Spain; Servicio de Endocrinología y Nutrición, Hospital San Juan de Dios, Santa Cruz de Tenerife, Spain.
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, Spain; Servicio de Endocrinología y Nutrición, Hospital San Juan de Dios, Santa Cruz de Tenerife, Spain.
Gastroenterol Hepatol. 2021 Mar;44(3):183-190. doi: 10.1016/j.gastrohep.2020.06.016. Epub 2020 Sep 15.
Recent evidence suggests that the number of low residue diet (LRD) days does not influence the bowel cleansing quality in non-selected patients. However, there are not data in the subgroup of patients with risk factors of inadequate bowel cleansing.
The aim of this study was to assess whether a 3-day LRD improved the bowel cleansing quality in patients with risk factors of poor bowel cleansing.
Post hoc analysis of a randomized controlled trial carried out between December 2017 and March 2018 in a tertiary care hospital. Patients with high risk of poor bowel cleansing were selected following a validated score. The patients 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. Intention-to-treat (ITT) and per-protocol (PP) analyses were conducted for the main outcome.
135 patients (1-day LRD group=67, 3-day LRD=68) were included. The rate of adequate cleansing quality was not significantly different between the groups in the ITT analysis: 76.1%, 95% CI: [64.6-84.8] vs. 79.4%, 95% CI: [68.2-87.4]; odds ratio (OR) 1.2, 95% CI [0.54-2.73]) or in the PP analysis: 77.3%, 95% CI: [65.7-85.8] vs. 80.3%, 95% CI: [69.0-88.3]; OR 1.2, 95% CI [0.52-2.77]). Compliance with the diet or cleansing solution, satisfaction or difficulties with the LRD and the polyp/adenoma detection rates were not significantly different.
Our results suggest that 1-day LRD is not inferior to 3-day LRD in patients with risk factors of inadequate bowel cleansing.
最近的证据表明，低渣饮食（LRD）天数并不会影响非选择性患者的肠道清洁质量。然而，在有肠道清洁不充分危险因素的患者亚组中尚无相关数据。
本研究旨在评估 3 天 LRD 是否可以改善有肠道清洁不充分危险因素的患者的肠道清洁质量。
这是一项在 2017 年 12 月至 2018 年 3 月在三级保健医院进行的随机对照试验的事后分析。选择采用验证评分法确定有肠道清洁不充分高风险的患者。患者被随机分为 1 天 LRD 组或 3 天 LRD 组。所有患者均接受 2L 聚乙二醇加抗坏血酸分剂量。对主要结局进行意向治疗（ITT）和方案治疗（PP）分析。
共纳入 135 例患者（1 天 LRD 组=67 例，3 天 LRD 组=68 例）。在 ITT 分析中，两组的充分清洁质量率无显著差异：76.1%，95%CI：[64.6-84.8] vs. 79.4%，95%CI：[68.2-87.4]；比值比（OR）为 1.2，95%CI[0.54-2.73]）或在 PP 分析中：77.3%，95%CI：[65.7-85.8] vs. 80.3%，95%CI：[69.0-88.3]；OR 为 1.2，95%CI[0.52-2.77]）。饮食或清洁溶液的依从性、对 LRD 的满意度或困难度以及息肉/腺瘤检出率无显著差异。
我们的结果表明，在有肠道清洁不充分危险因素的患者中，1 天 LRD 并不逊于 3 天 LRD。
