An intraprocedural bowel cleansing system for difficult-to-prepare patients-A multicenter prospective feasibility...

Area of Science:

• Gastroenterology
• Endoscopy
• Medical Devices

Background:

• Up to 20% of colonoscopies suffer from inadequate bowel preparation, impacting diagnostic accuracy.
• Inadequate preparation shares risk factors with failed cecal intubation, necessitating improved strategies.
• Patients with prior inadequate bowel preparation pose a specific challenge in colonoscopy.

Purpose of the Study:

• To evaluate the feasibility of an intraprocedural bowel cleansing system (BCS).
• To assess BCS efficacy in patients with a history of inadequate bowel preparation.
• To determine the impact of BCS on colonoscopy outcomes and safety.

Main Methods:

• A study involving 44 patients with a history of inadequate bowel preparation.
• Limited initial preparation followed by intraprocedural cleansing with the BCS.
• Primary outcome: adequate bowel preparation (Boston Bowel Preparation Scale); Secondary outcomes: cecal intubation, procedure time, usability, safety.

Main Results:

• Median Boston Bowel Preparation Scale score improved significantly (p < 0.0001), with adequate preparation rising from 31.8% to 88.6%.
• Cecal intubation rate was 88.6%, with 97.5% adequate cleansing in completed procedures.
• The BCS demonstrated good usability (median 4/5) and a favorable safety profile with no serious adverse events.

Conclusions:

• Intraprocedural BCS is effective for achieving adequate bowel cleansing in high-risk patients.
• This system may reduce repeat colonoscopies and associated healthcare utilization.
• Careful patient selection is recommended due to potential anatomical complexities in this patient group.