Document Detail


Different Bowel Preparation Schedule Leads to Different Diagnostic Yield of Proximal and Nonpolypoid Colorectal Neoplasm at Screening Colonoscopy in Average-Risk Population.
MedLine Citation:
PMID:  22067187     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Accumulating evidence indicates that the timing of bowel preparation is crucial, but its impact on the diagnostic yield of proximal or nonpolypoid colorectal neoplasm remains unclear. OBJECTIVE:: This study aimed to investigate the impact of the timing of bowel preparation on the adenoma detection rate for nonpolypoid colorectal neoplasm at colonoscopy. DESIGN:: This study is a retrospective analysis of a screening colonoscopy cohort database. SETTING:: The investigation was conducted at a screening colonoscopy unit in an university hospital. PATIENTS:: A consecutive series of 3079 subjects who received primary screening colonoscopy with different timing of bowel preparation was analyzed. INTERVENTION:: Different timing of bowel preparation (same day vs prior day) was studied. MAIN OUTCOME MEASURES:: The main outcomes measured were patient demographics, timing of bowel preparation, colon-cleansing levels, diagnostic yields of colonoscopy, including adenoma, advanced adenoma, and nonpolypoid colorectal neoplasm. RESULTS:: There were a total of 1552 subjects in the morning group and 1527 in the evening group. More subjects had proximal adenoma (175, 11.3% vs 138, 9.0%, P = .04), advanced adenoma (68, 4.4% vs 46, 13.0%, P = .044), nonpolypoid colorectal neoplasm (98, 6.3% vs 67, 4.4%, P = .018), proximal nonpolypoid colorectal neoplasm (71, 4.6% vs 40, 2.6%, P = .004), and advanced nonpolypoid colorectal neoplasm (25, 1.6% vs 12, 0.8%, P = .036) detected by same-day preparation. On multivariate regression analysis, the adenoma detection rate was significantly higher in the same-day group regarding overall and proximal adenoma (OR 1.23, 95% CI: 1.00-1.50; OR 1.35, 95% CI: 1.05-1.74), advanced adenoma (OR 1.53, 95% CI: 1.04-2.28), overall, proximal, and advanced nonpolypoid colorectal neoplasm (OR 1.48, 95% CI: 1.06-2.08; OR 1.82, 95% CI: 1.20-2.75; OR 1.96, 95% CI: 1.12-3.37). The adenoma detection rate was also significantly different among endoscopists. LIMITATION:: This was a single-center, nonrandomized trial. CONCLUSIONS:: Improving bowel preparation quality by same-day preparation may lead to enhanced detection of overall, proximal, and advanced nonpolypoid colorectal neoplasm.
Authors:
Han-Mo Chiu; Jaw-Town Lin; Yi-Chia Lee; Jin-Tung Liang; Chia-Tung Shun; Hsiu-Po Wang; Ming-Shiang Wu
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  54     ISSN:  1530-0358     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1570-1577     Citation Subset:  -    
Affiliation:
1 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan 2 Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan 3 Department of Pathology and Forensic Medicine, National Taiwan University Hospital, Taipei, Taiwan 4 Health Management Center, National Taiwan University Hospital, Taipei, Taiwan 5 Department of Primary Care Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan 6 Department of Internal Medicine, E-DA Hospital and I-Shou University, Kaohsiung County, Taiwan.
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