Endoscopy 2019; 51(04): S134
DOI: 10.1055/s-0039-1681564
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 10:30 – 11:00: Quality 1 ePoster Podium 7
Georg Thieme Verlag KG Stuttgart · New York

INFLUENCE OF BOWEL PREPARATION (BP) QUALITY ON THE DETECTION OF SERRATED POLYPS (SP): A PROSPECTIVE STUDY IN A REGIONAL FOBT-BASED COLORECTAL CANCER SCREENING PROGRAM

C Satorres
1   Gastrointestinal Endoscopy Unit, La Fe Polytechnic University Hospital, Valencia, Spain
2   Gastrointestinal Endoscopy Research Group, La Fa Health Research Institute, Valencia, Spain
,
M García-Campos
1   Gastrointestinal Endoscopy Unit, La Fe Polytechnic University Hospital, Valencia, Spain
,
N García-Morales
1   Gastrointestinal Endoscopy Unit, La Fe Polytechnic University Hospital, Valencia, Spain
,
N Alonso
1   Gastrointestinal Endoscopy Unit, La Fe Polytechnic University Hospital, Valencia, Spain
,
M Ponce
1   Gastrointestinal Endoscopy Unit, La Fe Polytechnic University Hospital, Valencia, Spain
2   Gastrointestinal Endoscopy Research Group, La Fa Health Research Institute, Valencia, Spain
,
L Argüello
1   Gastrointestinal Endoscopy Unit, La Fe Polytechnic University Hospital, Valencia, Spain
2   Gastrointestinal Endoscopy Research Group, La Fa Health Research Institute, Valencia, Spain
,
V Pons
1   Gastrointestinal Endoscopy Unit, La Fe Polytechnic University Hospital, Valencia, Spain
2   Gastrointestinal Endoscopy Research Group, La Fa Health Research Institute, Valencia, Spain
,
M Bustamante-Balen
1   Gastrointestinal Endoscopy Unit, La Fe Polytechnic University Hospital, Valencia, Spain
2   Gastrointestinal Endoscopy Research Group, La Fa Health Research Institute, Valencia, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

  1. To determine the influence of BP quality on the serrated polyp detection rate (SPDR);

  2. to describe the proportion of serrated lesions detected in second examinations performed after a poor-prepared initial screening colonoscopy.

Methods:

Prospective study in which all individuals referred for a screening colonoscopy after a positive FOBT between April 2017 and October 2018 were included. Only complete colonoscopies were considered. Six endoscopists and 3 pathologists participed. The Boston BP scale was used (0 – 5 = inadequate; 6 – 7 adequate; 8 – 9 good). The main outcome was SPDR. Secondary outcomes were ADR, advanced adenoma detection rates (AADR) and proximal SPDR.

Results:

In 718 of 750 patients (95.7%) cecum was intubated [women 334 (46,5%); mean (SD) age: 61.6 (5.8)]. A total of 2118 lesions were detected [1368 (64.6%) adenomas and 107 (5.0%) SP]. Overall SPDR was 10.3% (IC95% 10.3 – 15.3) while overall ADR was 67.3% (IC95% 63.5 – 71.0). The relationship of BP with SPDR and ADR is summarized in Tab. 1.

Tab. 1:

Relationship between bowel preparation and detection rates (*p < 0.05)

Bowel prep

ADR (%)

SPDR (%)

AADR (%)

SPDR-PC (%)

Adequate

68.6*

10.0

29.4*

5.6

Non-adequate

58.5

13.0

17.6

4.6

Boston≥2 every segment

69.0*

10.0

29.7*

5.8

Boston < 2 any segment

58.8

12.6

17.5

4.1

No relationship between SPDR and BP adjusted for age, sex, withdrawal time anendoscopist was found. Forty-four (54.3%) of the 81 reexaminations were because of poor BP. SPDR and ADR in these colonoscopies was 6.8% (IC95% 4.8 – 8.8) and 68.2% (IC95% 64.3 – 71.7) respectively. Presence of a SP in the initial endoscopy did not predict a SP in the reexamination.

Conclusions:

  1. Unlike ADR and AADR, SPDR is not influenced by BP.

  2. SPDR in reexaminations is similar to that of the initial colonoscopies.

A different approach to reexaminations depending on the initial findings is not warranted.