Sistema de Salut de Catalunya
[Pantaleón Sánchez M] Department of Gastroenterology, Hospital del Mar, Barcelona, Spain. [Gimeno Garcia AZ] Department of Gastroenterology, Hospital Universitario de Canarias, La Laguna, Spain. [Bernad Cabredo B] Department of Gastroenterology, Burgos University Hospital, Burgos, Spain. [García-Rodríguez A] Department of Gastroenterology, Hospital de Viladecans, Viladecans, Spain. [Frago S] Department of Gastroenterology, Complejo Asistencial de Soria, Soria, Spain. [Nogales O] Department of Gastroenterology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Romero Mascarell C] Servei de Gastroenterologia, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain
Consorci Sanitari de Terrassa
2023-06-22T06:49:34Z
2023-06-22T06:49:34Z
2022-09
Adenoma; Colonoscòpia; Tumors
Adenoma; Colonoscopy; Colonic neoplasms
Adenoma; Colonoscopia; Neoplasias del colon
Objectives: When bowel preparation (BP) is inadequate, international guidelines recommend repeating the colonoscopy within 1 year to avoid missing clinically relevant lesions. We aimed to determine the rate of missed lesions in patients with inadequate BP through a very early repeat colonoscopy with adequate BP. Methods: Post hoc analysis was conducted using data collected from a prospective multicenter randomized clinical trial including patients with inadequate BP and then repeat colonoscopy. Inadequate BP was defined as the Boston Bowel Preparation Scale (BBPS) score <2 points in any segment. We included patients with any indication for colonoscopy. The adenoma detection rate (ADR), advanced ADR (AADR), and serrated polyp detection rate (SPDR) were calculated for index and repeat colonoscopies. Results: Of the 651 patients with inadequate BP from the original trial, 413 (63.4%) achieved adequate BP on repeat colonoscopy. The median interval between index and repeat colonoscopies was 28 days. On repeat colonoscopy, the ADR was 45.3% (95% confidence interval [CI] 40.5-50.1%), the AADR was 10.9% (95% CI 8.1-14.3%), and the SPDR was 14.3% (95% CI 10.9-17.7%). Cancer was discovered in four patients (1%; 95% CI 0.2-2.5%). A total of 60.2% of all advanced adenoma (AA) were discovered on repeat colonoscopy. A colon segment scored BBPS = 0 had most AA (66.1%) and all four cancers. Conclusion: Patients with inadequate BP present a high rate of AAs on repeat colonoscopy. When a colonoscopy has a colon segment score BBPS = 0, we recommend repeating the colonoscopy as soon as possible.
Article
Published version
English
Adenoma; Colonoscòpia; Còlon - Càncer; DISEASES::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Adenoma; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Digestive System::Endoscopy, Digestive System::Endoscopy, Gastrointestinal::Colonoscopy; DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms::Colonic Neoplasms; ENFERMEDADES::neoplasias::neoplasias por tipo histológico::neoplasias glandulares y epiteliales::adenoma; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::técnicas diagnósticas digestivas::endoscopia digestiva::endoscopia gastrointestinal::colonoscopia; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias intestinales::neoplasias colorrectales::neoplasias del colon
Wiley
Digestive Endoscopy;34(6)
https://doi.org/10.1111/den.14278
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
