Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia

被引:660
作者
Harewood, GC
Sharma, VK
de Garmo, P
机构
[1] Mayo Clin, Div Gastroenterol & Hepatol, Rochester, MN 55905 USA
[2] Mayo Clin, Dept Gastroenterol, Scottsdale, AZ USA
[3] Oregon Hlth Sci Univ, Portland, OR 97201 USA
关键词
D O I
10.1067/mge.2003.294
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Suboptimal bowel preparation for colonoscopy can lead to missed colonic lesions. The aim of this study was to describe the impact of preparation quality on detection of suspected colonic neoplasia. Methods: Data from the Clinical Outcomes Research Initiative national endoscopic database for the period January 1, 2000 to December 31, 2001, were analyzed. Patient demographics, quality of preparation, and colonoscopy findings were abstracted from the database. Results: Overall, 93,004 colonoscopies with adequate documentation were reviewed. Preparation was adequate for 71,501 (76.9%) of these procedures. On multivariate analysis, preparation adequacy was associated with colonic lesion detection, odds ratio (OR) 1.21: 95% CI [1.16, 1.25]. Adequate preparation demonstrated a closer association with identification of "nonsignificant" lesions (polyps less than or equal to9 mm), OR 1.23: 95% CI [1.19,1.28], compared with "significant" lesion detection (mass lesion, polyps >9 mm), OR 1.05:95% CI [0.98, 1.11]. Conclusions: Bowel preparation is inadequate for almost a quarter of patients undergoing colonoscopy. These results suggest that inadequate preparation quality only hinders detection of smaller lesions, while having negligible impact on detection of larger lesions. These results should be confirmed in prospective studies.
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页码:76 / 79
页数:4
相关论文
共 18 条
[1]   A novel tableted purgative for colonoscopic preparation: efficacy and safety comparisons with Colyte and Fleet Phospho-Soda [J].
Aronchick, CA ;
Lipshutz, WH ;
Wright, SH ;
Dufrayne, F ;
Bergman, G .
GASTROINTESTINAL ENDOSCOPY, 2000, 52 (03) :346-352
[2]   PROSPECTIVE, RANDOMIZED, ENDOSCOPIC-BLINDED TRIAL COMPARING PRECOLONOSCOPY BOWEL CLEANSING METHODS [J].
COHEN, SM ;
WEXNER, SD ;
BINDEROW, SR ;
NOGUERAS, JJ ;
DANIEL, N ;
EHRENPREIS, ED ;
JENSEN, J ;
BONNER, GF ;
RUDERMAN, WB .
DISEASES OF THE COLON & RECTUM, 1994, 37 (07) :689-696
[3]  
*COMP COMM, 1992, STAND FORM CONT END
[4]   Randomised controlled trial of faecal-occult-blood screening for colorectal cancer [J].
Hardcastle, JD ;
Chamberlain, JO ;
Robinson, MHE ;
Moss, SM ;
Amar, SS ;
Balfour, TW ;
James, PD ;
Mangham, CM .
LANCET, 1996, 348 (9040) :1472-1477
[5]   Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings [J].
Imperiale, TF ;
Wagner, DR ;
Lin, CY ;
Larkin, GN ;
Rogge, JD ;
Ransohoff, DF .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 343 (03) :169-174
[6]  
KOLTS BE, 1993, AM J GASTROENTEROL, V88, P1218
[7]   Randomised study of screening for colorectal cancer with faecal-occult-blood test [J].
Kronborg, O ;
Fenger, C ;
Olsen, J ;
Jorgensen, OD ;
Sondergaard, O .
LANCET, 1996, 348 (9040) :1467-1471
[8]   Predicting advanced proximal colonic neoplasia with screening sigmoidoscopy [J].
Levin, TR ;
Palitz, A ;
Grossman, S ;
Conell, C ;
Finkler, L ;
Ackerson, L ;
Rumore, G ;
Selby, JV .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 281 (17) :1611-1617
[9]   Use of colonoscopy to screen asymptomatic adults for colorectal cancer [J].
Lieberman, DA ;
Weiss, DG ;
Bond, JH ;
Ahnen, DJ ;
Garewal, H ;
Chejfec, G ;
Harford, WV ;
Provenzale, D ;
Sontag, S ;
Schnell, T ;
Campbell, DR ;
Durbin, TE ;
Nelson, DB ;
Ewing, SL ;
Triadafilopoulos, G ;
Ramirez, FC ;
Lee, JG ;
Collins, JF ;
Fennerty, B ;
Johnston, TK ;
Corless, CT ;
McQuaid, KR ;
Sampliner, RE ;
Morales, TG ;
Fass, R ;
Smith, R ;
Maheshwari, Y .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 343 (03) :162-168
[10]   Patterns of endoscopy use in the United States [J].
Lieberman, DA ;
De Garmo, PL ;
Fleischer, DE ;
Eisen, GM ;
Helfand, M .
GASTROENTEROLOGY, 2000, 118 (03) :619-624