Impact of Bowel Preparation with Low-Volume (2-Liter) and Intermediate-Volume (3-Liter) Polyethylene Glycol on Colonoscopy Quality: A Prospective Observational Study.
OBJECTIVE
Two-liter polyethylene glycol (PEG) is the most commonly used bowel-cleansing regimen in Taiwan, but its efficacy is unsatisfactory. The aim of this study was to compare 2-liter and 3-liter PEG in terms of their impact on colonoscopy quality among an average-risk population.


METHODS
Two-liter PEG was provided between August 2012 and May 2013, while 3-liter PEG was provided between June 2013 and March 2014. A split-dose regimen was provided for morning colonoscopy and a same-day regimen was provided for afternoon colonoscopy. The level of bowel cleansing was prospectively scored.


RESULTS
A total of 407 consecutive subjects completed the 2-liter regimen, and another 407 consecutive subjects completed the 3-liter regimen. The 3-liter group had a significantly higher rate of excellent or good preparations, equivalent to a Boston bowel preparation scale of ≥7, than the 2-liter group (90 vs. 73%, p < 0.0001). More subjects in the 3-liter preparation group compared with the 2-liter group had overall adenoma (70 vs. 54%, p < 0.0001), proximal adenoma (47 vs. 35%, p = 0.0006), sessile serrated adenoma (28 vs. 6%, p < 0.0001), and advanced adenoma (21 vs. 9%, p < 0.0001).


CONCLUSIONS
Three-liter PEG provided better cleansing quality and higher adenoma detection rate than 2-liter PEG.
Division of Gastroenterology, Department of Medicine, Zhongli Evergreen Hospital, Taoyuan City, Taiwan.
Chi-Liang
CL
Cheng
Yen-Lin
YL
Kuo
Nai-Jen
NJ
Liu
Cheng-Hui
CH
Lin
Jui-Hsiang
JH
Tang
Yi-Ning
YN
Tsui
Bai-Ping
BP
Lee
Ming-Yao
MY
Su
Cheng-Tang
CT
Chiu
D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D002400:Cathartics / Q000008:administration & dosage*; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies
D002400:Cathartics; D011092:Polyethylene Glycols