Effectiveness and safety of a 1L polyethylene glycol and ascorbic acid preparation for colonoscopy in routine clinical practice in Spain.

BACKGROUND AND AIMS: Large clinical trials and small real-world studies show that a 1L polyethylene glycol and ascorbic acid solution (1L PEG-ASC) is an effective and safe bowel preparation for colonoscopy. Here, the effectiveness and safety of 1L PEG-ASC was evaluated in a large cohort of patients in routine clinical practice in Spain. METHODS: A sub-analysis was performed in an observational, multicenter, retrospective study assessing the effectiveness and safety of 1L PEG-ASC in adult patients undergoing a colonoscopy at 10 centers in Spain. Cleansing quality was assessed with the Boston Bowel Preparation Scale, scores ≥6 with all segmental scores ≥2 was considered adequate colon cleansing, high-quality was considered as cleansing ≥8 or =3 in the right colon. Polyp and adenoma detection rates, and adverse events were also assessed. RESULTS: Data was collected from 7160 patients: 48.3% males; mean age 58.0, 33.6% ≥65 years old. Adequate overall bowel cleansing was achieved in 95.6% of patients (95% CI 95.1%-96.0%), high quality cleansing in 74.4% (95% CI 73.4%-75.4%) and high-quality right colon cleansing in 66.0% (95% CI 64.9-67.1). The adequate overall cleansing rate was 97.0% with a split-dose and 94.0% with same-day regimen (P<0.0001), and high-quality right colon cleansing was 69.0% and 62.5% (P<0.0001), respectively. Colonoscopy was completed in 97.2% of cases. A multivariate regression analysis revealed that an overnight split-dose regimen and age <65 years were independent predictors of adequate bowel cleansing of the overall colon, age <65 years and female gender were independent predictors of HQ cleansing of the overall colon, and the three covariates were independent predictors of HQ cleansing of the right colon. At least one adverse event was experienced by 3.3% of participants, with nausea (1.5%) and vomiting (1.2%) being the most frequent. CONCLUSION: This sub-analysis confirmed 1L PEG-ASC to be an effective and safe bowel cleansing preparation in a real world setting in Spain.

Bowel cleansing effectiveness and safety of 1L PEG + Asc in the real-world setting: Observational, retrospective, multicenter study of over 13000 patients.

Background and study aims Effective bowel cleansing is critical for detecting lesions during colonoscopy, highlighting the importance of bowel preparations. 1L polyethylene glycol (PEG) + ascorbate (Asc) is the only recommended 1L PEG product in Europe and the United States. Its efficacy was demonstrated in large-scale controlled trials and confirmed in smaller-scale real-world studies. However, no large-scale real-world data exist. Patients and methods This observational, retrospective, multicenter study, used outpatient follow-up data from medical records from 10 centers in Spain and two in Portugal. Outpatients aged ≥18 years using 1L PEG + Asc as bowel preparation were included. The main outcome measures were overall adequate colon cleansing (Boston Bowel Preparation Scale [BBPS] score ≥6 with BBPS score ≥2 in each segment) and high-quality cleansing of the right colon (BBPS score=3). Results Data from 13169 eligible patients were included. Overall cleansing success was achieved in 89.3% (95%CI 88.7%-89.8%) and high-quality cleansing in the right colon in 49.3% (95%CI 48.4%-50.2%) of patients. For the overnight split-dose and same-day regimens, overall adequate quality cleansing success rate was 94.7% and 86.7% ( P <0.0001) and high-quality cleansing of the right colon rate was 65.4% and 41.4% ( P <0.0001), respectively. Colonoscopy was completed in 97.3% of patients, with non-completion due to poor preparation in only 0.8%; 2.3% of patients experienced at least one adverse event (AE). Conclusions This large-scale, real-world study demonstrates the effectiveness of 1L PEG + Asc in the total and right colon, with a low percentage of patients with AEs in routine clinical practice.

Las punciones esplénicas ecodirigidas por vía percutánea o guiadas por ecoendoscopia son procedimientos seguros y con un elevado rendimiento diagnóstico / No disponible

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Percutaneous and endoscopic ultrasound-guided splenic biopsies are both safe procedures with a high diagnostic accuracy.

Splenic biopsy is a necessary diagnostic procedure. It has been proved that it is a safe procedure with a high diagnostic accuracy. However, the decision of percutaneous or endoscopic ultrasound-guided approach should be assessed taking into consideration patients' characteristics and the experience of each center.

Safety and diagnostic accuracy of percutaneous ultrasound-guided biopsy of the spleen: a multicenter study.

PURPOSE: To analyze the safety and accuracy of ultrasound-guided (USG) percutaneous needle biopsy of the spleen. METHODS: Sixty-two USG needle biopsies performed in 52 patients were retrospectively analyzed: there were 53 biopsies of local lesions and 9 biopsies of diffuse lesions. Fine-needle aspiration (FNA) was performed in 37 cases and core-needle biopsy (CNB) in 25 cases. The complications and diagnostic accuracy of the 2 types of biopsy were compared. RESULTS: Two patients (3.8%) had postprocedural hemorrhage after CNB; one was minor, and the other severe, requiring splenectomy. No bleeding occurred with FNA. The diagnostic accuracy was similar with FNA (86.5%) and CNB (92%), whereas in patients with lymphoma, accuracy of FNA (80%) tended to be lower than that of CNB (100%), although the difference was not statistically significant. CONCLUSION: USG needle biopsy is safe and effective for diagnosing both focal and diffuse splenic lesions. The risk of bleeding may be lower with FNA than with CNB.