Abstract
Purpose. Our study aimed to identify an optimal full-cleanse bowel preparation scheme for patients undergoing CT colonography.Material and methods. The final sample included 118 patients: 81 females (68.6%), with the median age being 75 years (IQR 675-80 years). For bowel preparation 39 (33.1%) patients used PM/Ca, 36 (30.5%) – 2 L PEG + Asc, 19 (16.1%) – 3 L PEG, 24 (20.3%) – 4 L PEG. Otherwise, the preparation did not differ in all four groups. Visual assessment of residual stool, residual fluid, and distension degree was performed using a 4-point Likert scale. The patient’s subjective tolerance assessment was executed according to the survey results using a 5-point Likert scale.Results. There were no statistically significant differences in quality of bowel preparation in all four groups. Mean value of the total residual stool score in groups was 46.2 ± 2.87 for PM/Ca; 46.9 ± 2.34 for 2 L PEG + Asc; 46.5 ± 1.98 for 3 L PEG; 45.9 ± 3.18 for 4 L PEG (p > 0.05). The median of the total residual fluid score in groups was 36 (33–38) for PM/Ca; 36.5 (34–39) for 2 L PEG + Asc; 37 (36–39) for 3 L PEG; 36 (34–40) for 4 L PEG (p > 0.05). Mean value of the total distention degree score in groups was 43 ± 4.34 for PM/Ca; 44.6 ± 3.13 for 2 L PEG + Asc; 44.2 ± 3.98 for 3 L PEG; 43.5 ± 4.9 for 4 L PEG (p > 0.05). There was a statistically significant difference in the patient tolerance total score, depending on the laxative (p = 0.001). The total preparation score was significantly lower for PM/Ca when compared with 2 L PEG + Asc. (p = 0.021), 3 L PEG (p = 0.001), and 4 L PEG (p = 0.043).Conclusion. Use of PM/Ca in CTC preparation lowers the burden of full cleanse exam preparation and can be recommended as a safe laxative choice, including senior age patients.
Highlights
Colorectal cancer (CRC) is the second leading cause of cancer-related death and takes the third place of incidence among all human cancers in the world [1]
Use of PM/Ca in Computed-tomographic colonography (CTC) preparation lowers the burden of full cleanse exam preparation and can be recommended as a safe laxative choice, including senior age patients
In the 2 L polyethylene glycol (PEG) + Asc group, large polyps and CRC were found in two cases (5.9%), whereas diverticular disease in 14 cases
Summary
Colorectal cancer (CRC) is the second leading cause of cancer-related death and takes the third place of incidence among all human cancers in the world [1]. CRC screening, followed by polypectomy, decreases the risk of morbidity and mortality by 53% [2]. Computed-tomographic colonography (CTC) is a recommended radiological examination of choice for the diagnosis of colorectal neoplasia [3] and a method for CRC screening in the intermediate-risk group [4]. According to previous research, CTC requires a special bowel preparation, which is the most burdensome part of the whole procedure for patients [8, 9]. CTC preparation includes following a special diet, cathartics, and fecal tagging (FT) [10, 11]. CTC requires the same diet as in OC preparation and means excluding fiber-rich products [12]. Fecal tagging increases CTC’s sensitivity and specificity and is mandatory for CTC preparation [10, 13]
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