Determinación de tasa de adenomas desapercibidos en pacientes con riesgo promedio de cáncer colorrectal con preparación intestinal inadecuada

Abstract

IntroductionColonoscopy is the procedure of choice for the screening in average-risk colorectal cancer patients. Inadequate bowel preparation for a colonoscopy could result in not seeing lesions. These patients require a repeat procedure with a more complete colonic cleansing. The missed adenomas rate is one of the main risk factors in interval colonic cancer, and is one of the reasons why the procedure should be repeated. ObjectiveTo determine the missed adenomas rate in average-risk colorectal cancer patients with inadequate colonic cleansing by comparing two preparation groups in a second colonoscopy. MethodsA prospective, experimental, analytical, longitudinal and comparative design study was conducted on the second colonoscopy of two patient groups: An early preparation group (24hours), and late preparation group (after 24hours). Colonic cleansing, ileal and caecal intubation, polyps detected and resected in first and second colonoscopy were evaluated. ResultsA total of 52 patients were included, 21 (40.4%) with early preparation and 31 (59.6%) late preparation. Using the Boston scale, the mean preparation for the first colonoscopy was 4.37±0.81, and a mean of 8.24±0.83 in the second, and it was 6.81±0.91 in the late preparation (p=.0001). Polyp detection in the first colonoscopy was 5.76%, which increased to 30.7% in the second colonoscopy. ConclusionsMissed adenomas detection rate increased from 5.76% on first colonoscopy to 30.7% on the second. There was no difference between the preparation groups for polyp detection. An early preparation improves quality indicators in bowel cleansing, based on the Boston Scale, and ileal intubation.