scholarly journals Colon Irrigation Bowel Preparation Supports Multiple Clinical Benefits in Over 8,000 Patients

2021 ◽  
pp. 48
Author(s):  
Keyword(s):  
Bowel Preparation ◽  
High Volume ◽  
Serious Adverse Events ◽  
Detection Rates ◽  
Serrated Polyp ◽  
Adenoma Detection ◽  
Retrospective Clinical Study ◽  
Clinical Benefits ◽  
Colon Irrigation ◽  
High Level

This retrospective clinical study evaluates an FDA-cleared high-volume colon irrigation bowel prep (BP) for colonoscopy, performed under standard operating procedures with Austin Gastroenterology (AG, Austin, TX). Patient related outcomes in 8,364 procedures, prescribed by 33 physicians in 4.5 years, demonstrated no serious adverse events and excellent satisfaction rates. The high level of adequacy using this BP far exceeds national benchmarking thresholds for adequate colon preparations. Adequacy rates remain high even when considering poor BP risk factors and patient noncompliance with ancillary pre-preparation regimens. Our analysis demonstrates that this colon irrigation BP has excellent Boston bowel preparation scores (BBPS), associated with high-level adenoma detection rates (ADR) and sessile serrated polyp (SSP) detection rates. ADR and SSP are inversely related to the patient’s post-colonoscopy interval colorectal cancer (CRC) risk, and are similarly related to an inadequate BP. Both modeling data and performance characteristics strongly suggest that this colon irrigation BP is highly safe, effective, and will reduce the costs and risks related to inadequate BP. This, accordingly, leads to significantly improved quality outcomes, savings to the healthcare systems, and a reduction of the patient’s burden.

scholarly journals Comparing the Real-World Effectiveness of High- Versus Low-Volume Split Colonoscopy Preparations: An Experience Through the British Columbia Colon Cancer Screening Program

2020 ◽  
Author(s):  
Joseph G H Lee ◽  
Jennifer J Telford ◽  
Cherry Galorport ◽  
Jordan Yonge ◽  
Christopher A Macdonnell ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Bowel Preparation ◽  
Detection Rate ◽  
Screening Program ◽  
High Volume ◽  
Colon Cancer Screening ◽  
Detection Rates ◽  
Cancer Screening Program ◽  
Adenoma Detection ◽  
Low Volume

Abstract Background The British Columbia Colon Screening Program (BCCSP) is a population-based colon cancer screening program. In December 2018, physicians in Vancouver, Canada agreed to switch from a low-volume split preparation to a high-volume polyethylene glycol preparation after a meta-analysis of studies suggested superiority of the higher volume preparation in achieving adequate bowel cleansing and improving adenoma detection rates. Aims To compare the quality of bowel preparation and neoplasia detection rates using a high-volume split preparation (HVSP) versus a low-volume split preparation (LVSP) in patients undergoing colonoscopy in the BCCSP. Methods A retrospective review of patients undergoing colonoscopy through the BCCSP at St. Paul’s Hospital from July 2017 to November 2018 and December 2018 to November 2019 was conducted. Inclusion criteria included age 50 to 74 and patients undergoing colonoscopy through the BCCSP. Variables collected included patient demographics and bowel preparation quality. Rates of bowel preparation and neoplasia detection were analyzed using chi-squared test. Results A total of 1453 colonoscopies were included, 877 in the LVSP group and 576 in the HVSP group. No statistically significant difference was noted between rates of inadequate bowel preparation (LVSP 3.6% versus HVSP 2.8%; P = 0.364). Greater rates of excellent (48.4% versus 40.1%; P = 0.002) and optimal (90.1% versus 86.5%; P = 0.041) bowel preparation were achieved with HVSP. The overall adenoma detection rate was similar between the two groups (LVSP 53.1% versus HVSP 54.0%; P = 0.074). LVSP demonstrated higher overall sessile serrated lesion detection rate (9.5% versus 5.6%; P = 0.007). Conclusions Compared to LVSP, HVSP was associated with an increase in excellent and optimal bowel preparations, but without an improvement in overall neoplasia detection.

scholarly journals A149 COMPARING THE REAL-WORLD EFFECTIVENESS OF 4L VERSUS 2L SPLIT COLONOSCOPY PREPARATIONS: PRELIMINARY DATA OF A SINGLE CENTRE EXPERIENCE THROUGH THE BRITISH COLUMBIA COLONOSCOPY SCREENING PROGRAM

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 12-14
Author(s):  
J G Lee ◽  
J J Telford ◽  
C Galorport ◽  
J Yonge ◽  
C A Macdonnell ◽  
...  
Keyword(s):  
British Columbia ◽  
Bowel Preparation ◽  
Screening Program ◽  
High Volume ◽  
Preliminary Evaluation ◽  
Detection Rates ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Bowel Cleansing ◽  
History Of

Abstract Background The British Columbia Colon Screening Program (CSP) is a population-based program offering biennial fecal immunochemical test (FIT) to individuals age 50–74 years with follow-up colonoscopy for a positive FIT as well as individuals with a personal history of neoplastic polyps or a high risk family history of colorectal cancer. Over 20,000 colonoscopies are performed annually. In December 2018, program colonoscopists in Vancouver, Canada agreed to switch from a 2L polyethylene glycol (PEG) preparation to a 4L PEG preparation after studies suggested superiority of the higher volume preparation in achieving adequate bowel cleansing and improving adenoma detection rates (ADR). High quality bowel cleansing is critical to minimize repeat procedures and maximize neoplasia detection. Aims To compare the quality of bowel preparation and neoplasia detection rates using the 4L high volume split preparation (HVSP) versus the 2L low volume split preparation (LVSP) in patients undergoing colonoscopy in the BC CSP. Methods A retrospective review of consecutive patients undergoing colonoscopy through the CSP at St. Paul’s Hospital from Dec 2017-Apr 2018 and Dec 2018-Apr 2019 was conducted. Inclusion criteria included: age 50–74, patients undergoing colonoscopy for any reason through the BC CSP. Variables collected included: patient demographics, bowel preparation qualty and pathologic findings. ADR and sessile serrated polyp detection rate (SSDR) were analyzed. Results 462 colonoscopies were included, 280 in the LVSP group and 182 in the HVSP group. 8/280 (2.9%) had poor bowel preparation in the LVSP group, while 10/182 (5.5%) had poor bowel preparation in the HVSP group. The ADR and SSDR were 53.6% in LVSP vs. 50.0% in HVSP and 8.2% in LVSP vs. 8.8% in HVSP, respectively. Conclusions In this preliminary evaluation, the high volume PEG-based split preparation did not reduce the proportion of inadequate bowel preparations. Further evaluation of a larger number of colonoscopies is planned. Funding Agencies None

scholarly journals Good is better than excellent: bowel preparation quality and adenoma detection rates

2015 ◽  
Vol 81 (3) ◽  
pp. 691-699.e1 ◽  
Author(s):  
Audrey H. Calderwood ◽  
Katherine D. Thompson ◽  
Paul C. Schroy ◽  
David A. Lieberman ◽  
Brian C. Jacobson
Keyword(s):  
Bowel Preparation ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Adenoma Detection Rates ◽  
Better Than

Endocuff-assisted colonoscopy is associated with a lower adenoma miss rate: a multicenter randomized tandem study

Endoscopy ◽  
2017 ◽  
Vol 49 (11) ◽  
pp. 1051-1060 ◽  
Author(s):  
Konstantinos Triantafyllou ◽  
Dimitrios Polymeros ◽  
Periklis Apostolopoulos ◽  
Catarina Lopes Brandao ◽  
Paraskevas Gkolfakis ◽  
...  
Keyword(s):  
Proximal Colon ◽  
Conventional Colonoscopy ◽  
Advanced Adenoma ◽  
Serious Adverse Events ◽  
Colon Adenoma ◽  
Detection Rates ◽  
Index Procedure ◽  
Adenoma Detection ◽  
Adenoma Detection Rates ◽  
Medical Design

Abstract Background and study aims The Endocuff (ARC Medical Design, Leeds, UK) is a device that, when mounted on the tip of an endoscope, may assist with inspection of a greater surface of the colonic mucosa by pulling backwards, flattening, and stretching the colonic folds as the endoscope is gradually withdrawn. We aimed to compare the adenoma miss rates of Endocuff-assisted colonoscopy with those of conventional colonoscopy. Patients and methods The included patients underwent same-day, back-to-back, (Endocuff-assisted colonoscopy as the index procedure followed by conventional colonoscopy or vice versa, randomly assigned 1:1) colonoscopies, performed by six endoscopists with documented adenoma detection rates > 35 %, in four tertiary endoscopy facilities. Results We randomized 200 patients (mean age 61.2 years [standard deviation 9.8]; 86.5 % colorectal cancer screening surveillance cases). Overall, there were seven incomplete examinations using Endocuff and one with conventional colonoscopy (P = 0.03). Times for endoscope insertion (5.0 minutes [0.8 – 21.0] vs. 5.0 minutes [1.0 – 16.0]; P = 0.49) and withdrawal (6.0 minutes [3.2 – 29.0] vs. 6.0 minutes [3.1 – 17.0]; P = 0.06) were similar for Endocuff-assisted and conventional colonoscopy. We detected one cancer and 195 adenomas; 84 in the proximal colon. Endocuff-assisted colonoscopy showed significantly lower overall and proximal colon adenoma miss rates compared with conventional colonoscopy (14.7 % [8.0 % – 21.0 %] vs. 38.4 % [28.1 % – 48.6 %] and 10.4 % [1.8 % – 19.1 %] vs. 38.9 % [23.0 % – 54.8 %], respectively). No difference between the two arms was shown regarding advanced adenoma miss rates, either overall or in the proximal colon. There were no serious adverse events related to the procedures. Conclusions In comparison with conventional colonoscopy, Endocuff-assisted colonoscopy has a significantly lower adenoma miss rate when performed by high-detector endoscopists. However, the incomplete colonoscopy rate with Endocuff is higher.ClinicalTrials.gov Identifier: NCT02340065.

scholarly journals Assessment of tolerance and acceptability between mannitol solution and polyethylene glycol as bowel preparation for colonoscopy: a three-center study

2020 ◽  
Vol 40 (1) ◽  
pp. 7
Author(s):  
Jean Félix Piñerúa-Gonsálvez ◽  
Rosanna del Carmen Zambrano-Infantino ◽  
Alberto Alberto ◽  
Mariseli Sulbaran ◽  
Noheltriz Camaray
Keyword(s):  
Polyethylene Glycol ◽  
Bowel Preparation ◽  
Detection Rates ◽  
Mannitol Solution ◽  
Adenoma Detection ◽  
Bowel Diseases ◽  
Adenoma Detection Rates ◽  
Healthcare Expenses ◽  
Unpleasant Experience ◽  
Major Impediment

Introduction: Adequate bowel preparation is one of the most important factors related to the yield of colonoscopy. Low-quality bowel preparation has been associated with lower adenoma detection rates and increased healthcare expenses. Bowel preparation is a major impediment to undergo colonoscopy since it is perceived as an unpleasant experience by patients. Objective: This study was aimed to assess tolerance and acceptability of the bowel preparation using either polyethylene glycol (PEG) or mannitol solution. Materials and methods: We enrolled 140 patients with indications of screening for colorectal cancer or with suspected large bowel diseases. They received either mannitol solution or PEG as bowel preparation. Patients were asked to fill a questionnaire about the bowel preparation experience. Results: Patients perceived more burdensome the preparation with PEG than mannitol for the variables nausea overall experience, post-procedure discomfort, disagreeable flavor, volume ingested and cost (p<0.05). A similar tolerance was reported for abdominal pain, bloating and anal irritation (p>0.05). The acceptability was 82.9% and 71.4% in the Mannitol group and in the PEG group, respectively (p=0.10). Conclusion: Acceptance of the bowel preparation between mannitol solution and PEG was comparable. However, mannitol was bettertolerated by the patients in regard to most of the evaluated items.

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