IDDF2023-ABS-0156 Poor tolerance of bowel preparation for index colonoscopy decreases surveillance rate in high-risk adenoma removal patients

A. Higashimori, Natsumi Naeda, M. Nakatani, Ikki Yamamoto, Tsuyoshi Yanagida, Daiyu Kin, K. Morimoto, E. Sasaki, T. Fukuda, Tesuo Arakawa, Y. Fujiwara
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Abstract

IDDF-2023-ABS-0156 Table 1Association between Tolerance of BP for index colonoscopy and surveillance rateTolerance of BP for index colonoscopy Surveillance rate% (n/N) Total 67% (127/186) 1. Very intolerable 47% (9/19) 2. Intolerable 48% (10/21) 3. Neither tolerable nor intolerable 76% (55/72) 4. Tolerable 71% (22/31) 5. Very tolerable 72% (31/43) P for trend test 0.04 IDDF2023-ABS-0156 Table 2Risk factors of non-compliance of surveillance colonoscopy by multivariate regression analysis Multivariate OR (95%CI) p value Age,/1-year increase 1.04 (1.03-1.05) 0.001 Male sex 1.13 (0.85-1.52) 0.40 BMI,/1-kg/m2 increase 1.05 (0.96-1.15) 0.28 Family history of CRC 0.93 (0.16-5.25) 0.92 Low education 0.92 (0.39-2.15) 0.90 Comorbidities 1.05 (0.51-2.13) 0.90 Low tolerance of BP for colonoscopy 2.45 (1.11-5.41) 0.006 Absence of primary care physician 4.63 (1.60-13.4) 0.001 BMI: body mass index, CRC: colorectal cancer, BP: bowel preparation IDDF2023-ABS-0156 Table 3The reasons of non-compliance surveillance colonoscopyReasons of non-compliance surveillance colonoscopy n, (%) Total 62 (100%) Not knowing about follow-up intervals 4 (6%) Having no symptoms 15 (24%) Fear of examination Pain during colonoscopy 1 (2%) Embarrassment during colonoscopy 0 (0%) Bowel preparation for colonoscopy 17 (28%) Over sedation during colonoscopy 2 (3%) Old age/severe illness for surveillance 10 (16%) Having no time 10 (16%) Having no money 1 (2%) Fear of Covid-19 infection 2 (3%) IDDF2023-ABS-0156 Figure 1ConclusionsOur findings highlight the need for improvement of the surveillance colonoscopy rate, especially for patients who had poor tolerance to BP on index colonoscopy and no gastroenterology visit. Providing a well-tolerated BP regimen may lead to an increase in surveillance colonoscopy compliance.
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肠准备对指数结肠镜检查的耐受性差降低了高危腺瘤切除患者的监测率
表1指数结肠镜下血压耐受性与监测率的关系指数结肠镜下血压耐受性监测率% (n/ n)总计67% (127/186)非常难以忍受47% (9/19)无法忍受的48% (10/21)既不能容忍也不能容忍76% (55/72)可容忍71% (22/31)表2多因素回归分析监测结肠镜不依从性的危险因素多因素OR (95%CI) P值年龄/1年增加1.04(1.03-1.05)0.001男性性别1.13 (0.85-1.52)0.40 BMI /1-kg/m2增加1.05 (0.96-1.15)0.28 CRC家族史0.93(0.16-5.25)0.92低文化程度0.92(0.39-2.15)0.90合共病1.05(0.51-2.13)0.90结肠镜血压耐受度低2.45 (1.11-5.41)0.006缺少初级保健医生4.63 (1.60-13.4)0.001 BMI:身体质量指数,CRC:结直肠癌,BP:表3监测性结肠镜检查不符合的原因(%)共62例(100%)不知道随访间隔4(6%)无症状15(24%)害怕检查结肠镜检查时疼痛1(2%)结肠镜检查时尴尬0(0%)结肠镜检查前肠道准备17(28%)结肠镜检查时过度镇静2(3%)老年/严重疾病监测10(16%)没有时间10(16%)没有钱1(2%)害怕Covid-19感染2 (3%)IDDF2023-ABS-0156图1结论研究结果强调了改进的必要性监测结肠镜检查率,特别是对指数结肠镜对BP耐受性差且没有胃肠病学就诊的患者。提供耐受性良好的BP方案可能会增加结肠镜检查依从性。
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