Split dosing with a low-volume preparation is not inferior to split dosing with a high-volume preparation for bowel cleansing in patients with a history of colorectal resection: a randomized trial.
Endoscopy
; 47(10): 917-24, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-25910064
ABSTRACT
BACKGROUND AND STUDY AIM:
The study compared the efficacy of bowel cleansing using a low-volume mixed preparation (15âmg bisacodyl plus 2âL polyethylene glycol [PEG] solution) versus a standard high-volume preparation (4âL PEG) in patients with previous colorectal resection. PATIENTS ANDMETHODS:
A total of 120 patients with prior colorectal resection for cancer undergoing surveillance colonoscopy were randomized to receive either a split-dose low-volume (nâ=â60) or high-volume (nâ=â60) preparation for bowel cleansing. The quality of bowel preparation, rated according to a modified Ottawa Bowel Preparation scale (mOBPS), represented the primary outcome measure. Tolerability, safety, and lesion detection rates were secondary outcomes.RESULTS:
No significant difference was observed between the low-volume and high-volume preparations in achievement of adequate cleansing (i.âe. mOBPS ≤â4; low-volume vs. high-volume group, 85.0â% vs. 81.7â%, Pâ=â0.624). The low-volume preparation showed a higher success rate for cleansing of the right colon (Pâ=â0.025); better tolerability in terms of intake of the whole amount of the preparation (Pâ<â0.001) was also observed. According to the logistic regression analysis, the only predictors of unsuccessful cleansing were previous left colectomy (Pâ=â0.012) and a longer elapsed time since the intervention (Pâ=â0.034). Lesion detection rates were comparable between the groups. No serious adverse events were reported.CONCLUSION:
A low-volume preparation is not inferior to a high-volume preparation for adequate bowel cleansing in patients with prior colorectal resection for cancer. If larger, multicenter, prospective studies confirm our findings, a low-volume preparation will represent a more tolerable option for such patients. TRIAL REGISTRATION NUMBER ClinicalTrial.gov identifier NCT01887158.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Polietilenoglicóis
/
Bisacodil
/
Catárticos
/
Colonoscopia
/
Colectomia
/
Colo
/
Ácido Cítrico
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Itália