Authors (including presenting author) :
Kwok LH, Lau CM, Lee MH, Chan MK, Fu KS, Ng LK, Pang SY, To SH
Affiliation :
Department of Surgery, Ruttonjee and Tang Shiu Kin Hospitals
Introduction :
Colonoscopy is the gold-standard procedure for detecting colorectal lesions and the removal of polyps. Its efficiency depends on the quality of bowel cleansing. Thus, inadequate bowel preparation leads to suboptimal effectiveness, However, we noticed the rate of inadequate bowel preparation in AM colonoscopy (18.8%) was much higher when compare to PM colonoscopy (3.7%) in our department. After reviewing related literatures, which demonstrated a better efficacy in the quality of bowel preparation when a split dose regimen is used for AM colonoscopies.
Objectives :
To improve the quality of bowel cleansing for patient who undergo AM colonoscopies.
Methodology :
A retrospective cohort study was commenced in January, 2024. We changed the bowel preparation from single dose (2 Litres in the night before colonoscopy) to split dose by administer 1 Litre of the preparation in the previous night and the remaining 1 Litre in the morning before the procedure.
The bowel preparation results are retrieved from the colonoscopy record in which the surgeons will comment the degree of bowel cleanliness by using Boston Bowel Preparation Scale (BBPS). Each region of the colon receives a “segment score” from 0 to 3 and these segment scores are summed for a total BBPS score ranging from 0 to 9. The maximum BBPS score for a perfectly clean colon is 9. It is generally accepted that a BBPS score ≥ 6 is adequate.
Result & Outcome :
From 1st January to 31st October, 2024, 136 patients were recruited to the split-dose group. 95.6% showed adequate bowel preparation and the remaining 4.4% showed inadequate bowel preparation. There were also 258 patients using previous single-dose bowel preparation. 84.9% showed adequate bowel preparation and the remaining 15.1% showed inadequate bowel preparation. The relative risk of this study is 0.29 (95%CI is 0.127 to 0.672) which favor the split-dose regimen over single-dose regimen in terms of bowel cleansing. Therefore ,by using the split dose, the risk of poor bowel preparation would reduce to 29% when comparing to the non-split dose.
The result demonstrated the split-dose regimen produced better bowel cleansing effect over the single-dose regimen.
