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Impact of Bowel Preparation Quality on Adenoma Identification During Colonoscopy and Optimal Timing of Surveillance

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Abstract

Background

All present guidelines regarding surveillance intervals after index colonoscopy are based on optimal bowel preparation. However, the appropriate timing of repeat colonoscopy after suboptimal bowel preparation is not clear.

Aims

To determine the appropriate timing of repeat colonoscopy following index colonoscopy with suboptimal bowel preparation.

Methods

The medical records of patients who underwent colonoscopy over 5 years were retrospectively analyzed. Index colonoscopy was defined as the first colonoscopy in patients who underwent the procedure at least twice during the study period. Bowel preparation quality was classified as optimal, fair, or poor.

Results

The overall adenoma detection rate was 39.1 % (95 % confidence interval [CI], 38.0–40.1 %), but the detection rate depended significantly on bowel preparation quality (p < 0.001). The adenoma miss rate (AMR) was significant after poor (69.6 %) than after optimal (27.3 %) and fair (48.1 %) preparation (p < 0.001). At surveillance intervals ≤2 years, the odds ratio (OR) for AMR was significantly higher for poor (OR 6.25; 95 % CI, 3.76–11.83) and fair (OR 3.67; 95 % CI, 2.19–6.16) preparation relative to optimal preparation; however, no difference was observed at surveillance intervals >2 years.

Conclusions

Bowel preparation quality significantly affects AMR. Colonoscopy should be repeated within 2 years in patients with suboptimal bowel preparation at index colonoscopy.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea

    Ju Seok Kim, Sun Hyung Kang, Hee Seok Moon, Eaum Seok Lee, Seok Hyun Kim, Jae Kyu Sung, Byung Seok Lee & Hyun Yong Jeong

  2. Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea

    Woo Suk Chung

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  1. Ju Seok Kim
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Correspondence to Sun Hyung Kang.

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Kim, J.S., Kang, S.H., Moon, H.S. et al. Impact of Bowel Preparation Quality on Adenoma Identification During Colonoscopy and Optimal Timing of Surveillance. Dig Dis Sci 60, 3092–3099 (2015). https://doi.org/10.1007/s10620-015-3737-2

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  • DOI: https://doi.org/10.1007/s10620-015-3737-2

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