Inadeguata preparazione (BBPS:1) impone controllo a 1 anno

Predict the Risk of Missed Neoplasia on Next Colonoscopy.Kluge MA, Williams JL, Wu CK, Jacobson BC, Schroy PC 3rd, Lieberman DA, Calderwood AH. Gastrointest Endosc. 2017 Jun 22. [Epub ahead of print]


BACKGROUND AND AIMS:The risks of missed findings after inadequate bowel preparation are not fully characterized in a diverse cohort. We aimed to evaluate the likelihood of missed polyps after an inadequate preparation as assessed using the Boston Bowel Preparation Scale (BBPS).

METHODS:In this observational study of prospectively collected data within a large, national endoscopic consortium, we identified patients aged 50 to 75 who underwent average-risk screening colonoscopy (C1) followed by a second colonoscopy for any indication within 3 years (C2). We determined the polyp detection rates (PDR) and advanced PDR during C2 stratified by C1 BBPS scores.RESULTS:Among segment pairs without polyps at C1 (N=601), those with inadequate C1 BBPS segment scores had higher PDR at C2 (10%) compared with those with adequate C1 (5%, p=0.04). Among segment pairs with polyps at C1 (N=154), segments with inadequate C1 scores had higher advanced PDR at C2 (20%) compared with those with adequate C1 (4%, p=0.03). In multivariable analysis, the presence of advanced polyps at C1 (adjusted OR, 3.5; 95% CI, 1.1-10.8), but not inadequate BBPS scores at C1 (adjusted OR, 1.8; 95% CI, 0.6-5.1), was associated with a significantly increased risk of advanced polyps at C2.CONCLUSIONS:Inadequate BBPS segment scores are generally associated with higher rates of polyps and advanced polyps at subsequent colonoscopy within a short timeframe. The presence of advanced polyps as well as inadequate BBPS segment scores can inform the risk of missed polyps and help triage which patients warrant a timely repeat colonoscopy.

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