Prevalence of Missed Lesions in Patients with Inadequate Bowel Preparation Through a Very Early Repeat Colonoscopy

Aims We aimed to determine the rate of missed lesions on patients with inadequate bowel preparation, through a very early repeat colonoscopy with adequate bowel preparation.

Methods Post-hoc analysis using data collected from a prospective multicenter randomized clinical trial (RTC) including patients with inadequate bowel preparation and then repeat colonoscopy within 6 months. Inadequate bowel preparation was defined as a Boston Bowel Preparation Scale (BBPS) score <2 in any segment. We included patients with any indication for colonoscopy. The adenoma detection rate (ADR), advanced ADR (AADR), serrated polyp detection rate (SPDR), were calculated for the index and repeat colonoscopies.

Results Of the 651 patients with inadequate bowel preparation from the original RTC, 66 patients (10.1 %) were excluded due to partial colectomy. Of the 585 whom were analyzed, 530 (90.6 %) underwent repeat colonoscopy within 6 months from baseline colonoscopy and 413 (70.6 %) achieved an adequate bowel preparation on the repeat colonoscopy. Mean of total BBPS score was 2.3 (SD 1.8) and 7 (SD 1.2) on baseline and repeat colonoscopy, respectively. On repeat colonoscopy, the ADR was 45.3 % (95 % CI 40.5 % to 50.1 %), the AADR was 10.9 % (95 % CI 7.9 % to 13.9 %) and the SPDR was 14.3 (95 % CI 10.9 % to 17.7 %). The per-adenoma miss rate was 68.9 % (95 %CI 65.2 % to 72.6 %), the per-advanced adenoma miss rate was 60.64 % (95 %CI 50.8 % to 70.5 %), and the per-serrated miss rate was 83.8 % (95 % CI 77.5 % to 90.2 %).

Conclusions Patients with inadequate bowel preparation present a high rate of adenoma, advanced adenomas and serrated lesions on the repeat colonoscopy. 6 months might be a reasonable interval for repeating the examination.

Citation: Pantaleón Sánchez MA, Gimeno-García AZ, Bernad Cabredo B et al. OP132 PREVALENCE OF MISSED LESIONS IN PATIENTS WITH INADEQUATE BOWEL PREPARATION THROUGH A VERY EARLY REPEAT COLONOSCOPY. Endoscopy 2021; 53: S54.

Publication History

Article published online:
19 March 2021