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• W2912077199 abstract "Introduction: Bowel preparation is a key determinant of colonoscopy quality, particularly when performed for colorectal cancer screening. Underwater colonoscopy (UW), performed using water exchange or water immersion techniques, has been suggested to improve bowel prep scores compared to air insufflation colonoscopy (AI). Objective: Determine if UW, compared to AI, are associated with higher rates of adequate bowel prep scores Methods: Colonoscopy quality data was collected prospectively at our single tertiary referral center beginning in June 2012. For this study, the dataset included all colonoscopies performed for screening or surveillance indications for which UW and AI were recorded (September 2014 to May 2017). 5037 colonoscopies, including 2841 underwater (UW) and 2196 air insufflation colonoscopies (AI), were included. These two groups were compared with respect to mean Boston Bowel Prep Scores (BBPS) overall and by location within colon, as well for number of procedures with “adequate” bowel prep, defined as an average BBPS score ≥8.0. Subgroup analysis was conducted on basis of gender, race and BMI. Statistical analysis was performed using unpaired T-test and Fischer's exact test. Results: Compared to AI, UW was associated with higher BBPS overall (7.8 vs. 8.0, p = 0.007), as well as in the transverse (2.6 vs. 2.7, p = 0.003), and left colon (2.6 vs. 2.7, p = 0.002). UW was also associated with significantly higher percentage of procedures with adequate bowel prep (73.2% vs. 76.5%, p = 0.009). On subgroup analysis, UW was associated with higher rates of adequate bowel preparation in women (75.2% vs 78.6%, p = 0.03), normal BMI individuals (73.1% vs. 78.3%, p = 0.006), and Caucasians (71.7% vs. 75.2%, p = 0.02). Liters of bowel preparation utilized was similar between the two groups (3.46L vs. 3.53L, p = 0.22). Conclusion: Adequate bowel preparation is necessary to allow for thorough inspection of the colon during screening and surveillance colonoscopy. Inadequate prep may obscure smaller or more subtle lesions, such as sessile adenomas, allowing them to progress towards malignancy. UW technique has many benefits, including improved patient tolerance, lower sedation requirements and higher adenoma detection rates. Our results indicate that UW is also associated with improved bowel preparation, providing further support for use of UW.Table: Table. Mean Boston Bowel Prep Scores (BBPS) in AI vs. UWTable: Table. Comparison of Rates of Adequate Bowel Prep in AI vs. UW" @default.
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• W2912077199 date "2017-10-01" @default.
• W2912077199 modified "2023-09-26" @default.
• W2912077199 title "Clean and Clear Colonoscopy: Underwater Insertion Techniques Associated With Higher Rates of Adequate Bowel Prep" @default.
• W2912077199 doi "https://doi.org/10.14309/00000434-201710001-00507" @default.
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