Ascorbic acid PEG-2L is superior for early morning colonoscopies in colorectal cancer screening programs: A prospective non-randomized controlled trial

作者：Rodriguez de Miguel C; Serradesanferm A; Lopez Ceron M; Carballal S; Pozo A; Balaguer F; Cardenas A; Fernandez Esparrach G; Gines A; Gonzalez Suarez B; Moreira L; Ordas I; Ricart E; Sendino O; Vaquero E C; Ubre M; del Manzano S; Grau J; Llach J; Castells A; Pellise M^*

来源：Gastroenterologia y Hepatologia, 2015, 38(2): 62-70.

DOI：10.1016/j.gastrohep.2014.09.007

• Colonoscopy
• Bowel cleansing
• Preparation
• Colorectal cancer screening
• Quality endoscopy
• Clinical trial

Background: The quality of colon cleansing and the tolerability of anterograde preparation are essential to the success of colorectal cancer screening.
Aim: To compare the tolerability and efficacy of low-volume preparations vs the standard regimen in individuals scheduled for an early morning colonoscopy.
Study: Participants in a population-based colorectal cancer screening program using the fecal immunochemical test who were scheduled for a colonoscopy from 09:00 a. m. to 10:20 a.m. were prospectively included and assigned to: (1) control group (PEG-ELS 4L): PEG 4 L and electrolytes; (2) group AscPEG-2L: a combination of PEG and ascorbic acid 2L; and (3) group PiMg: sodium picosulfate and magnesium citrate 500 mL plus 2 L of clear fluids. Tolerability was evaluated with a questionnaire and the quality of bowel preparation with the Boston Bowel Preparation Scale.
Results: A total of 292 participants were included: 98 in the PEG-ELS 4L control group, 96 in the AscPEG-2L study group and 98 in the PiMg study group. Low-volume treatments were better tolerated than the standard solution (AscPEG-2L 94.8% and PiMg 93.9% vs PEG-ELS 4L 75.5%; p < 0.0001). The effectiveness of AscPEG-2L was superior to that of PEG-ELS 4L and PiMg (p = 0.011 and p = 0.032, respectively). Patient acceptance was higher for single-dose than for split-dose administration but efficacy was higher with the split dose than with other doses.
Conclusions: In early morning colonoscopies, ascPEG-2L appears to be the best option, especially when administered in a split-dose.

• 出版日期2015-2