Of the 651 patients with inadequate bowel preparation, 63.4% achieved adequate preparation on repeat colonoscopy.
The median time between the initial and repeat colonoscopy was 28 days.
On repeat colonoscopy, the was 45.3%.
Advanced adenomas were detected at a rate of 10.9% during repeat procedures.
Serrated polyps were identified in 14.3% of repeat colonoscopies.
Cancer was found in four patients, representing 1% of cases.
A significant proportion (60.2%) of advanced adenomas were discovered during repeat colonoscopy.
Simplified
OBJECTIVES: When bowel preparation (BP) is inadequate, international guidelines recommend repeating the colonoscopy within 1 year to avoid missing clinically relevant lesions. We aimed to determine the rate of missed lesions in patients with inadequate BP through a very early repeat colonoscopy with adequate BP.
METHODS: Post hoc analysis was conducted using data collected from a prospective multicenter randomized clinical trial including patients with inadequate BP and then repeat colonoscopy. Inadequate BP was defined as the Boston Bowel Preparation Scale (BBPS) score <2 points in any segment. We included patients with any indication for colonoscopy. The (ADR), advanced ADR (AADR), and serrated polyp detection rate (SPDR) were calculated for index and repeat colonoscopies.
RESULTS: Of the 651 patients with inadequate BP from the original trial, 413 (63.4%) achieved adequate BP on repeat colonoscopy. The median interval between index and repeat colonoscopies was 28 days. On repeat colonoscopy, the ADR was 45.3% (95% confidence interval [CI] 40.5-50.1%), the AADR was 10.9% (95% CI 8.1-14.3%), and the SPDR was 14.3% (95% CI 10.9-17.7%). Cancer was discovered in four patients (1%; 95% CI 0.2-2.5%). A total of 60.2% of all (AA) were discovered on repeat colonoscopy. A colon segment scored BBPS = 0 had most AA (66.1%) and all four cancers.
CONCLUSION: Patients with inadequate BP present a high rate of AAs on repeat colonoscopy. When a colonoscopy has a colon segment score BBPS = 0, we recommend repeating the colonoscopy as soon as possible.
Key numbers
45.3%
Detection rate during repeat colonoscopy after inadequate BP
10.9%
Detection Rate
Detection rate of advanced adenomas during repeat colonoscopy
60.2%
Miss Rate for Advanced Adenomas
Per- miss rate calculated from index and repeat colonoscopies
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Author M.A.A.‐G. has received honoraria for advisory board attendance, speaking and teaching from Norgine Ltd, and for speaking and teaching from Casen‐Recordati. The other authors declare no conflict of interest for this article.
