Marcello Maida, Roberto Vassallo, Vitello Alessandro, Angelo Zullo, Ludovica Venezia, Antonio Facciorusso
Department of Medicine and Surgery, University of Enna 'Kore', 94100 Enna, Italy.
Gastroenterology Unit, Umberto I Hospital, 94100 Enna, Italy.
Cancers (Basel). 2025 Apr 24;17(9):1421. doi: 10.3390/cancers17091421.
To assess the impact of bowel cleansing quality on polyp detection rate (PDR) and adenoma detection rate (ADR) and explore predictors of lesion detection rate in patients undergoing colonoscopy.
This is a post-hoc analysis of a multicenter randomized controlled trial (RCT) comparing 1L polyethylene glycol plus ascorbate (1L PEG+ASC) vs. 4L PEG as bowel preparation for colonoscopy.
PDR was significantly higher (35.6% vs. 18.5%, = 0.013), and ADR was higher even if not significantly (25.6% vs. 16.7%, = 0.153) in patients with Boston Bowel Preparation Scale (BBPS) ≥6 over BBPS <6. Comparing patients with BBPS = 9 over BBPS = 7-8, no significant differences were found in PDR (34.5% vs. 38.4%, = 0.483) nor ADR (24.1% vs. 27.2%, = 0.553). At multivariable regression analysis, older age (OR = 1.042, 95%CI = 1.021-1.063; < 0.001), shorter intubation time (OR = 0.891, 95%CI = 0.816-0.972; = 0.010), higher withdrawal time (OR = 1.171, 95%CI = 1.094-1.253; < 0.001) and full consumption of the first dose (OR = 8.368, 95%CI = 1.025-68.331; = 0.047) were independently associated with ADR.
This post-hoc analysis of a RCT showed that excellent cleansing (BBPS = 9) over high-quality cleansing (BBPS = 7-8) does not significantly improve PDR or ADR. Neither cleansing success nor preparation types were independently associated with ADR. Compliance with bowel preparation, timing of colonoscopy and withdrawal time are key elements for adequate ADR with potential implications for reducing interval colorectal cancer.
评估肠道清洁质量对息肉检出率（PDR）和腺瘤检出率（ADR）的影响，并探讨结肠镜检查患者病变检出率的预测因素。
这是一项对多中心随机对照试验（RCT）的事后分析，该试验比较了1L聚乙二醇加抗坏血酸盐（1L PEG+ASC）与4L聚乙二醇作为结肠镜检查肠道准备的效果。
波士顿肠道准备量表（BBPS）≥6的患者的PDR显著更高（35.6%对18.5%，P = 0.013），ADR也更高，即使差异不显著（25.6%对16.7%，P = 0.153）。比较BBPS = 9的患者和BBPS = 7 - 8的患者，PDR（34.5%对38.4%，P = 0.483）和ADR（24.1%对27.2%，P = 0.553）均无显著差异。在多变量回归分析中，年龄较大（OR = 1.042，95%CI = 1.021 - 1.063；P < 0.001）、插管时间较短（OR = 0.891，95%CI = 0.816 - 0.972；P = 0.010）、退镜时间较长（OR = 1.171，95%CI = 1.094 - 1.253；P < 0.001）和第一剂完全服用（OR = 8.368，95%CI = 1.025 - 68.331；P = 0.047）与ADR独立相关。
这项对RCT的事后分析表明，与高质量清洁（BBPS = 7 - 8）相比，极佳清洁（BBPS = 9）并不能显著提高PDR或ADR。清洁成功与否和准备类型均与ADR无独立关联。肠道准备的依从性、结肠镜检查时间和退镜时间是获得足够ADR的关键因素，可能对降低间期结直肠癌有影响。
