Improved bowel preparation increases polyp detection and unmasks significant polyp miss rate

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Colonoscopy is crucial for colorectal cancer screening and diagnosis.
• Bowel preparation quality significantly impacts colonoscopy effectiveness.
• Optimizing bowel preparation is essential for accurate polyp detection.

Purpose of the Study:

• To compare the efficacy of split-dose versus previous-day bowel preparation.
• To evaluate the impact of preparation method on bowel cleanliness.
• To assess polyp detection rates and miss rates in patients undergoing polypectomy.

Main Methods:

• Retrospective comparison of two colonoscopy procedures per patient.
• Inclusion of 50 patients referred for polypectomy.
• Evaluation of bowel cleansing using the Aronchick scale and polyp detection/miss rates.

Main Results:

• Split-dose preparation (92%) showed significantly better bowel cleanliness than previous-day preparation (76%).
• Split-dose preparation was associated with a higher number of detected polyps overall and in both right and left colon.
• Polyp miss rates were 25.4% overall, with higher rates for diminutive polyps.

Conclusions:

• Split-dose bowel preparation is superior to previous-day preparation for colon cleansing.
• Enhanced bowel cleanliness with split-dose preparation leads to improved polyp detection.
• The study highlights the importance of optimal bowel preparation in reducing polyp miss rates.