Excellent Bowel Preparation Quality Is Not Superior to Good Bowel Preparation Quality for Improving Adenoma/Polyp Detection Rate.

IF 1.9 4区医学 Q3 ONCOLOGY

Clinical Medicine Insights-Oncology Pub Date : 2024-02-07 eCollection Date: 2024-01-01 DOI:10.1177/11795549241229190

Yingchao Li, Fanjun Meng, Rongrong Cao, Cong Gao, Dongshuai Su, Ke Wang, Jie Han, Xingshun Qi

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引用次数: 0

Abstract

Background: Adequate bowel preparation quality is essential for high-quality colonoscopy according to the current guidelines. However, the excellent effect of bowel preparation on adenoma/polyp detection rate (ADR/PDR) remained controversial.

Methods: During the period from December 2020 to August 2022, a total of 1566 consecutive patients underwent colonoscopy by an endoscopist. Their medical records were reviewed. According to the Boston bowel preparation scale, patients were divided into excellent, good, and poor bowel preparation quality groups. ADR/PDR, diminutive ADR/PDR, small ADR/PDR, intermediate ADR/PDR, large ADR/PDR, and number of adenomas/polyps were compared among them. Logistic regression analyses were performed to identify the factors that were significantly associated with ADR/PDR.

Results: Overall, 1232 patients were included, of whom 463, 636, and 133 were assigned to the excellent, good, and poor groups, respectively. The good group had a significantly higher ADR/PDR (63% vs 55%, P = .015) and a larger number of adenomas/polyps (2.5 ± 3.2 vs 2.0 ± 2.8, P = .030) than the poor group. Both ADR/PDR (63% vs 55%, P = .097) and number of adenomas/polyps (2.2 ± 2.8 vs 2.0 ± 2.8, P = .219) were not significantly different between excellent and poor groups. The excellent (9% vs 4%, P = .045) and good (9% vs 4%, P = .040) groups had a significantly higher intermediate ADR/PDR than the poor group. Logistic regression analyses showed that either good (odds ratio [OR] = 1.786, 95% CI = 1.046-3.047, P = .034) or excellent (OR = 2.179, 95% CI = 1.241-3.826, P = .007) bowel preparation quality was independently associated with a higher ADR/PDR compared with poor bowel preparation quality. Excellent (OR = 1.202, 95% CI = 0.848-1.704, P = .302) bowel preparation quality was not independently associated with a higher ADR/PDR compared with good bowel preparation quality.

Conclusions: The pursuit of excellence in bowel preparation does not show an association with increased ADR/PDR and number of adenomas/polyps compared with a good level. In addition, our study further contributes to the existing evidence that poor bowel preparation compromises ADR/PDR and number of adenomas/polyps.

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在提高腺瘤/息肉检出率方面，肠道制备质量优异并不比肠道制备质量良好更有优势。

背景：根据现行指南，充分的肠道准备质量对高质量结肠镜检查至关重要。然而，肠道准备对腺瘤/息肉检出率（ADR/PDR）的卓越效果仍存在争议：方法：在 2020 年 12 月至 2022 年 8 月期间，共有 1566 名连续患者接受了内镜医师的结肠镜检查。对他们的病历进行了审查。根据波士顿肠道准备量表，将患者分为肠道准备质量优、良、差三组。比较他们的 ADR/PDR、微小 ADR/PDR、小 ADR/PDR、中等 ADR/PDR、大 ADR/PDR、腺瘤/息肉数量。通过逻辑回归分析确定与 ADR/PDR 显著相关的因素：结果：总共纳入了 1232 例患者，其中 463 例、636 例和 133 例分别被分配到优秀组、良好组和不良组。优良组的 ADR/PDR 明显高于不良组（63% vs 55%，P = .015），腺瘤/息肉数量也多于不良组（2.5 ± 3.2 vs 2.0 ± 2.8，P = .030）。优秀组和不良组的 ADR/PDR（63% vs 55%，P = .097）和腺瘤/息肉数量（2.2 ± 2.8 vs 2.0 ± 2.8，P = .219）均无显著差异。优秀组（9% vs 4%，P = .045）和良好组（9% vs 4%，P = .040）的中间 ADR/PDR 明显高于不良组。逻辑回归分析显示，与肠道准备质量差相比，肠道准备质量好（几率比 [OR] = 1.786，95% CI = 1.046-3.047，P = .034）或优秀（OR = 2.179，95% CI = 1.241-3.826，P = .007）与 ADR/PDR 高独立相关。与良好的肠道准备质量相比，优秀的肠道准备质量（OR = 1.202，95% CI = 0.848-1.704，P = .302）与较高的 ADR/PDR 无关：结论：与良好水平相比，追求卓越的肠道准备与 ADR/PDR 和腺瘤/息肉数量的增加并无关联。此外，我们的研究进一步补充了现有的证据，即肠道准备质量差会影响 ADR/PDR 和腺瘤/息肉的数量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Medicine Insights-Oncology Medicine-Oncology

CiteScore

2.40

自引率

4.50%

发文量

审稿时长

8 weeks

期刊介绍： Clinical Medicine Insights: Oncology is an international, peer-reviewed, open access journal that focuses on all aspects of cancer research and treatment, in addition to related genetic, pathophysiological and epidemiological topics. Of particular but not exclusive importance are molecular biology, clinical interventions, controlled trials, therapeutics, pharmacology and drug delivery, and techniques of cancer surgery. The journal welcomes unsolicited article proposals.