Diagnostic yield of early repeat colonoscopy after suboptimal bowel preparation in a fecal immunochemical test-based screening program.
Endoscopy
; 52(12): 1093-1100, 2020 12.
Article
en En
| MEDLINE
| ID: mdl-32583393
ABSTRACT
BACKGROUND:
Current guidelines regarding surveillance after screening colonoscopy assume adequate bowel preparation. However, follow-up intervals after suboptimal cleansing are highly heterogeneous. We aimed to determine the diagnostic yield of early repeat colonoscopy in patients with suboptimal bowel preparation in fecal immunochemical test (FIT)-based screening colonoscopy.METHODS:
An observational study including patients who underwent colonoscopy with suboptimal bowel preparation after positive FIT screening and then repeat colonoscopy within 1 year. Suboptimal preparation was defined as a Boston Bowel Preparation Scale (BBPS) score of 1 in any segment. Patients with a BBPS score of 0 in any segment or incomplete examination were excluded. The adenoma detection rate (ADR), advanced ADR (AADR), and colorectal cancer rate were calculated for the index and repeat colonoscopies.RESULTS:
Of the 2474 patients with FIT-positive colonoscopy at our center during this period, 314 (12.7â%) had suboptimal preparation. Of the 259 (82.5â%) patients who underwent repeat colonoscopy, suboptimal cleansing persisted in 22 (9â%). On repeat colonoscopy, the ADR was 38.7â% (95â%CI 32.6â% to 44.8â%) and the AADR was 14.9â% (95â%CI 10.5â% to 19.4â%). The per-adenoma miss rate was 27.7â% (95â%CI 24.0â% to 31.6â%), and the per-advanced adenoma miss rate was 17.6â% (95â%CI 13.3â% to 22.7â%). After repeat colonoscopy, the post-polypectomy surveillance recommendation changed from 10 to 3 years in 14.7â% of the patients with previous 10-year surveillance recommendation.CONCLUSIONS:
Patients with suboptimal bowel preparation on FIT-positive colonoscopy present a high rate of advanced adenomas in repeat colonoscopy, with major changes in post-polypectomy surveillance recommendations.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Colorrectales
/
Adenoma
/
Neoplasias del Colon
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Screening_studies
Límite:
Humans
Idioma:
En
Revista:
Endoscopy
Año:
2020
Tipo del documento:
Article
País de afiliación:
España