Outcomes of Next-Day Versus Non-next-Day Colonoscopy After an Initial Inadequate Bowel Preparation.
BACKGROUND
Inadequate bowel preparation is the most common cause of failed colonoscopy, and repeat failure occurs in more than 20 % of follow-up attempts. Limited data suggest that next-day follow-up may reduce the risk for repeat inadequate preparation.


OBJECTIVE
Evaluate differences in prep quality with next-day follow-up after initial inadequate preparation.


METHODS
Retrospective study.


METHODS
Academic center.


METHODS
Outpatient screening and surveillance colonoscopies between 7/2002 and 6/2007.


METHODS
Comparison of next-day versus any other day ("non-next-day") repeat colonoscopy outcomes.


METHODS
Aronchick scale, polyp and adenoma detection rates.


RESULTS
Of 20,798 initial colonoscopies, 857 (4.1 %) had inadequate preparation. 460 (54 %) were lost to follow-up. One hundred and fourteen (13 %) had next-day and 283 (33 %) had non-next-day colonoscopy with mean follow-up of 8.8 months. On follow-up examination, 29.8 % of next-day and 23.3 % of non-next-day colonoscopies had inadequate bowel preparation (p = 0.48). The adenoma detection rate for the next-day group improved from 3.5 to 38.6 % on follow-up, compared to 20.5 and 36.8 % in the non-next-day group. There was no significant difference between groups in detection of total adenoma (p = 0.73) or advanced adenomas (p = 0.20) on follow-up examinations.


CONCLUSIONS
Retrospective design, differences in baseline colonoscopy characteristics.


CONCLUSIONS
The results confirm the need for repeat examination after a colonoscopy with inadequate bowel prep, as there was substantial increase in adenoma detection on follow-up. There were no differences in outcomes between next-day versus non-next-day colonoscopy. These data support repeating after inadequate colonoscopy within 1 year as convenient for patient and physician.
University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Christopher John
CJ
Murphy
University of Utah Health Sciences Center, Salt Lake City, UT, USA.
N
N
Jewel Samadder
University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Kristen
K
Cox
University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Ronak
R
Iqbal
University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Brian
B
So
University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Daniel
D
Croxford
University of Utah Health Sciences Center, Salt Lake City, UT, USA. john.fang@hsc.utah.edu.
John C
JC
Fang
D000046:Academic Medical Centers; D018256:Adenomatous Polyps / Q000473:pathology*; D000284:Administration, Oral; D000368:Aged; D003106:Colon / Q000473:pathology*; D003110:Colonic Neoplasms / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D054368:Laxatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D007507:Therapeutic Irrigation / Q000379:methods*; D013997:Time Factors; D017211:Treatment Failure
D054368:Laxatives; D011092:Polyethylene Glycols; C000595212:polyethylene glycol 3350
Colon cancer screening; Colonoscopy; Colonoscopy preparation; Inadequate bowel preparation