Ben-Horin S, Bar-Meir S, Avidan B. The outcome of a second preparation for colonoscopy after preparation failure in the first procedure.
Gastrointest Endosc 2009;
69:626-30. [PMID:
19251002 DOI:
10.1016/j.gie.2008.08.027]
[Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Accepted: 08/21/2008] [Indexed: 02/08/2023]
Abstract
BACKGROUND
There are scant data regarding the outcome of consecutive repeated procedures in patients who failed to adequately clean their colon for colonoscopy.
OBJECTIVE
To investigate the outcome of a second colonoscopy after preparation-associated failure of the first colonoscopy.
DESIGN AND SETTING
A retrospective study in a tertiary-referral center.
PATIENTS
All patients with failure of colonoscopy because of poor preparation within a 1-year period.
RESULTS
Of a total of 6990 colonoscopies performed during the study period, 307 procedures (4.4%) failed because of inadequate preparation. Data on subsequent repeated colonoscopies were available for 235 patients. The repeated procedure again failed because of unsatisfactory preparation in 54 of these patients (23%). The failure rate in subsequent third and fourth colonoscopies was also high (more than 25%). Of the various patient and procedure-related parameters examined, only the use of calcium channel blockers (CCB) was found to be predictive of a failed repeated preparation (odds ratio [OR] 3.2 [95% CI, 1.6-6.3], P < .001). In contrast, a next-day colonoscopy after failure of the index procedure was associated with a reduced risk of unsatisfactory second preparation (OR 0.31 [95% CI, 0.1-0.92], P = .03).
LIMITATIONS
Validated data on the specific bowel purgatives used were not available.
CONCLUSIONS
Almost a fourth of patients with an unacceptable colonic preparation will also fail the repeated colonoscopy, and patients who use CCB are at particular risk for failure. Strategies to manage this difficult-to-treat patient group should be investigated and may possibly include a preference for next-day colonoscopy.
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