BACKGROUND & AIMS:
PURPOSE:Polyethylene glycol gut lavage is an effective bowel preparation for colonoscopy. The quality of the preparation is not uniform however, and most studies report a rate of suboptimal cleansing of 10 percent or more. One of the possible reasons for a poor preparation is the length of time between the lavage and the examination. The aim of this study was to assess the effect of timing of polyethylene glycol gut lavage on the quality of the preparation achieved.
METHODS:Patients referred for elective outpatient colonoscopy with afternoon appointments were randomized to take polyethylene glycol gut lavage either the same morning as their examination (Group 1) or the afternoon of the day before (Group 2). The colonoscopist was unaware of the preparation timing until after the examination was over. During the examination the endoscopist scored the quality of bowel preparation in the cecum, ascending colon, and transverse and left colon. Patient demographics and clinical data were recorded.
RESULTS:There were 157 patients in Group 1 (colonoscopy complete in 152 patients) and 160 in Group 2 (colonoscopy complete in 159 patients). The groups were similar in age and gender, indication for colonoscopy, and previous colonic surgery. Patients who drank gut lavage on the morning of their colonoscopy had a greatly better preparation in all areas of the colon than the patients who took their preparation the night before. In the cecum, 97 Group 1 patients had an excellent preparation (vs. 14 Group 2 patients), 45 had a good preparation (vs. 103 Group 2 patients), and 10 had a fair preparation (vs. 33 Group 2 patients). In the ascending colon, numbers of patients with excellent, good, fair, and poor results were 103, 45, 5, and 0 for Group 1 and 12, 107, 32, and 7 for Group 2. Results in the transverse and left colons were 102, 50, 5, 0 and 93, 55, 7, 2 for Group 1 and 15, 116, 27, 5 and 18, 114, 24, 3 for Group 2, respectively.
CONCLUSION:The timing of administration of polyethylene glycol-based gut lavage is a major determinant of the quality of the bowel preparation achieved.
背景与目标:
目的:灌洗聚乙二醇是肠镜检查的有效肠道准备。但是,制剂的质量并不统一,大多数研究报告称次优清洁率达10%或更高。准备不充分的可能原因之一是灌洗和检查之间的时间间隔。这项研究的目的是评估定时灌洗聚乙二醇对制备质量的影响。
方法:将接受择期门诊结肠镜检查并下午预约的患者在检查的同一天早上(第1组)或前一天下午(第2组)随机抽取聚乙二醇肠灌洗液。结肠镜检查者直到检查结束才知道准备时间。在检查过程中,内镜医师对盲肠,升结肠,横结肠和左结肠的肠准备质量进行了评分。记录患者的人口统计资料和临床数据。
结果:第一组157例(结肠镜检查完成152例),第二组160例(结肠镜检查完成159例)。两组的年龄和性别,结肠镜检查指征和以前的结肠手术相似。在结肠镜检查的早晨喝肠道灌洗的患者在结肠的所有区域的准备要比前一天晚上进行肠道准备的患者好得多。在盲肠中,有97例第一组患者具有良好的准备(对14例第二组患者),45例具有良好的制剂(对103例第二组患者)和10例具有良好的制剂(对33例第二组患者)。在升结肠中,第1组的结果为优异,良好,中等和较差的患者数量分别为103、45、5和0,第2组的结果为12、107、32和7。第1组分别为102、50、5、0和93、55、7、2,第2组分别为15、116、27、5和18、114、24、3。
结论:基于聚乙二醇的肠灌洗的给药时间是决定肠准备质量的主要决定因素。