Efficacy and tolerability of high and low-volume bowel preparation compared:A real-life single-blinded large-population study  

作　　者：Vincenzo Occhipinti Paola Soriani Francesco Bagolini Valentina Milani Emanuele Rondonotti Maria Laura Annunziata Flaminia Cavallaro Sara Vavassori Maurizio Vecchi Luca Pastorelli Gian Eugenio Tontini 

机构地区：[1]Digestive Endoscopy and Gastroenterology Unit,A.Manzoni Hospital,ASST Lecco,Lecco 23900,Italy [2]Gastroenterology Unit,IRCCS Policlinico San Donato,San Donato Milanese 20097,Italy [3]Gastroenterology and Digestive Endoscopy Unit,Azienda USL Modena,Carpi Hospital,Carpi 41012,Italy [4]Scientific Directorate,IRCCS Policlinico San Donato,San Donato Milanese 20097,Italy [5]Gastroenterology Unit,Ospedale Valduce,Como 22100,Italy [6]Gastroenterology and Endoscopy Unit,Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico,Milan 20122,Italy [7]Gastroenterology and Hepatology Unit,ASST Santi Paolo e Carlo,Milan 20142,Italy [8]Department of Pathophysiology and Transplantation,University of Milan,Milan 20122,Italy [9]Department of Biomedical Sciences for Health,University of Milan,Milan 20122,Italy

出　　处：《World Journal of Gastrointestinal Endoscopy》2021年第12期659-672,共14页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Low-volume preparations for colonoscopy have shown similar efficacy compared to high-volume ones in randomized controlled trials(RCT).However,most RCTs do not provide data about clinical outcomes including lesions detection rate.Moreover,real-life comparisons are lacking.AIM To compare efficacy(both in terms of adequate bowel preparation and detection of colorectal lesions)and tolerability of a high-volume(HV:4 L polyethylene glycol,PEG)and a low-volume(LV:2 L PEG plus bisacodyl)bowel preparation in a real-life setting.METHODS Consecutive outpatients referred for colonoscopy were prospectively enrolled between 1 December 2014 and 31 December 2016.Patients could choose either LV or HV preparation,with a day-before schedule for morning colonoscopies and a split-dose for afternoon procedures.Adequate bowel preparation according to Boston Bowel Preparation Scale(BBPS),clinical outcomes including polyp detection rate(PDR),adenoma detection rate(ADR),advanced adenoma detection rate(AADR),sessile/serrated lesion detection rate(SDR)and cancer detection rate and self-reported tolerability of HV and LV were blindly assessed.RESULTS Total 2040 patients were enrolled and 1815(mean age 60.6 years,50.2%men)finally included.LV was chosen by 52%of patients(50.8%of men,54.9%of women).Split-dose schedule was more common with HV(44.7%vs 38.2%,P=0.005).High-definition scopes were used in 33.4%of patients,without difference in the two groups(P=0.605).HV and LV preparations showed similar adequate bowel preparation rates(89.2%vs 86.6%,P=0.098),also considering the two different schedules(HV split-dose 93.8%vs LV split-dose 93.6%,P=1;HV daybefore 85.5%vs LV day-before 82.3%,P=0.182).Mean global BBPS score was higher for HV preparations(7.1±1.7 vs 6.8±1.6,P<0.001).After adjustment for sex,age and indications for colonoscopy,HV preparation resulted higher in PDR[Odds ratio(OR)1.32,95%CI:1.07-1.63,P=0.011]and ADR(OR 1.29,95%CI 1.02–1.63,P=0.038)and comparable to LV in AADR(OR 1.51,95%CI 0.97-2.35,P=0.069),SDR and cancer det

关 键 词：Bowel preparation volume Polyethylene glycol BISACODYL COLONOSCOPY Colonic adenomas TOLERABILITY 

分 类 号：R574.62[医药卫生—消化系统]