A low-volume polyethylene glycol solution was associated with an increased suboptimal bowel preparation rate but had similar recommendations for an early repeat colonoscopy, procedure times, and adenoma detection rates

作者：Hankins Sam C; Brimhall Bryan B; Kank****a Vineel; Austin Gregory L^*

来源：PLos One, 2017, 12(4): e0176265.

DOI：10.1371/journal.pone.0176265

Background/Aims
Low-volume polyethylene glycol (PEG) bowel preparations are better tolerated by patients than high-volume preparations and may achieve similar preparation quality. However, there is little data comparing their effects on a recommendation for an early repeat colonoscopy (because of a suboptimal preparation), procedure times, adenoma detection rate (ADR), and advanced adenoma detection rate (AADR).
Methods
This is a retrospective cohort study of outpatient colonoscopies performed during a oneyear period at a single academic medical center in which low-volume MoviPrep (R) (n = 1841) or high-volume Colyte (R) (n = 1337) was used. All preparations were split-dosed. Appropriate covariates were included in regression models assessing suboptimal preparation quality (fair, poor, or inadequate), procedure times, recommendation for an early repeat colonoscopy, ADR, and AADR.
Results
MoviPrep (R) was associated with an increase in having a suboptimal bowel preparation (OR 1.36; 95% CI: 1.06-1.76), but it was not associated with differences in insertion (p = 0.43), withdrawal (p = 0.22), or total procedure times (p = 0.10). The adjusted percentage with a suboptimal preparation was 11.7% for patients using MoviPrep (R) and 8.8% for patients using Colyte (R). MoviPrep (R) was not associated with a significant difference in overall ADR (OR 0.93; 95% CI: 0.78-1.11), AADR (OR 1.18; 95% CI: 0.87-1.62), or recommendation for early repeat colonoscopy (OR 1.16; 95% CI: 0.72-1.88).
Conclusions
MoviPrep (R) was associated with a small absolute increase in having a suboptimal preparation, but did not affect recommendations for an early repeat colonoscopy, procedure times, or adenoma detection rates. Mechanisms to reduce financial barriers limiting low- volume preparations should be considered because of their favorable tolerability profile.

• 出版日期2017-4-27