Herman Tessa, Wongjarupong Nicha, Wilson Natalie, Megna Bryant, Are Vijay, Westanmo Anders, Lou Susan, Bilal Mohammad, Hanson Brian J
Department of Medicine, University of Minnesota Medical Center, Minneapolis, United States.
Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota Medical Center, Minneapolis, United States.
Endosc Int Open. 2024 Jun 6;12(6):E750-E756. doi: 10.1055/a-2316-7638. eCollection 2024 Jun.
Inadequate bowel preparation is common despite various preprocedure interventions. There is a need for an intervention at the time of colonoscopy to combat poor preparation. In this retrospective, observational study of 46 patients, we evaluated the clinical efficacy and feasibility of implementing the third generation of the Pure-Vu EVS System, a US Food and Drug Administration-cleared over-the-scope-based intraprocedural cleansing device, into our practice at the Minneapolis VA Medical Center (Minneapolis, Minnesota, United States). To study clinical efficacy, we measured bowel preparation adequacy before and after using the device, as measured by the Boston Bowel Preparation Score, and reviewed colonoscopy surveillance interval recommendations. Technical success and feasibility of using the device were measured by procedure success rates and duration. We found that BBPS scores increased from 4.4 to 7.9 when using the device. Technical success was achieved 78.3% of the time (36/46 cases). Median colonoscopy duration was 46 minutes, although there was a trend toward shorter procedures over time. This is the first clinical evaluation of the third generation of an intraprocedural cleansing device. We found the device efficacious and easy to use with low procedure failure rates, but it does come with a learning curve. We suspect that adoption of this device mutually will benefit patients and health systems with the potential to improve resource utilization.
尽管采取了各种术前干预措施，但肠道准备不充分的情况仍很常见。在结肠镜检查时需要采取一种干预措施来应对准备不足的问题。在这项对46名患者的回顾性观察研究中，我们评估了在明尼阿波利斯退伍军人医疗中心（美国明尼苏达州明尼阿波利斯）将第三代Pure-Vu EVS系统（一种经美国食品药品监督管理局批准的基于内镜的术中清洁设备）应用于我们的实践中的临床疗效和可行性。为了研究临床疗效，我们通过波士顿肠道准备评分来测量使用该设备前后的肠道准备充分程度，并审查结肠镜检查监测间隔建议。使用该设备的技术成功率和持续时间来衡量其技术成功和可行性。我们发现使用该设备时，波士顿肠道准备评分从4.4提高到了7.9。技术成功率为78.3%（46例中的36例）。结肠镜检查的中位持续时间为46分钟，尽管随着时间的推移有手术时间缩短的趋势。这是对第三代术中清洁设备的首次临床评估。我们发现该设备有效且易于使用，手术失败率低，但确实存在学习曲线。我们怀疑采用这种设备将使患者和医疗系统相互受益，有可能提高资源利用率。
