Intraprocedural cleansing work during colonoscopy and achievable rates of adequate preparation in an open-access endoscopy unit

Margaret E. MacPhail, Kyle A. Hardacker, Ashish Tiwari, Krishna C. Vemulapalli, Douglas Rex

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Rates of adequate bowel preparation in the 60% to 80% range continue to be reported for colonoscopy. Objective: To describe the rate of adequate bowel preparation and intraprocedural work needed to achieve this rate in an open-access endoscopy unit. Universal split dosing and regimens tailored to medical predictors of inadequate preparation were used. Design: Prospective observational study. Setting: Academic hospital outpatient endoscopy unit and ambulatory surgery center. Patients: Outpatients undergoing colonoscopy. Interventions: Prospective assessment of preparation quality for colonoscopy during insertion and after intraprocedural cleansing in 525 patients. Main Outcome Measurements: Rates of adequate preparation and work required to improve cleansing quality. Work time for cleaning was measured with a stopwatch. Results: Adequate preparation to allow recommendation of standard screening or surveillance intervals was achieved in 96% of patients, including 6% for whom preparation was adequate only after intraprocedural cleansing work. The mean time for intraprocedural cleaning was 4.1 minutes and constituted 17% of total procedure time. Work time for cleaning and fluid volume injected increased when worse preparation grades were identified before cleaning. Limitations: Single-center study with low percentage (4%) of patients receiving Medicaid. Conclusion: An open-access unit using split-dose bowel cleansing preparations can achieve high rates of adequate bowel preparation for colonoscopy. Intraprocedural cleansing accounts for a substantial fraction of the total procedure time in colonoscopy and is an important contributor to high rates of adequate preparation.

Original languageEnglish
Pages (from-to)525-530
Number of pages6
JournalGastrointestinal Endoscopy
Volume81
Issue number3
DOIs
StatePublished - Mar 1 2015

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Colonoscopy
Endoscopy
Outpatients
Medicaid
Ambulatory Surgical Procedures
Observational Studies
Prospective Studies

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

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Intraprocedural cleansing work during colonoscopy and achievable rates of adequate preparation in an open-access endoscopy unit. / MacPhail, Margaret E.; Hardacker, Kyle A.; Tiwari, Ashish; Vemulapalli, Krishna C.; Rex, Douglas.

In: Gastrointestinal Endoscopy, Vol. 81, No. 3, 01.03.2015, p. 525-530.

Research output: Contribution to journalArticle

MacPhail, Margaret E. ; Hardacker, Kyle A. ; Tiwari, Ashish ; Vemulapalli, Krishna C. ; Rex, Douglas. / Intraprocedural cleansing work during colonoscopy and achievable rates of adequate preparation in an open-access endoscopy unit. In: Gastrointestinal Endoscopy. 2015 ; Vol. 81, No. 3. pp. 525-530.
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