Original articleClinical endoscopyPrevalence of missed adenomas in patients with inadequate bowel preparation on screening colonoscopy
Section snippets
Methods
This study was conducted at the outpatient endoscopy center at Washington University in St. Louis School of Medicine and Barnes-Jewish Hospital and was reviewed and approved by the institutional review board. A waiver of informed consent was obtained given the study's retrospective nature. Data were collected via the electronic institutional database.
By using our outpatient endoscopy database, screening colonoscopies performed between August 1, 2004 and July 31, 2009 were collected. Initial
Results
Figure 1 summarizes our study design and patient inclusion for analysis. Initial search criteria of our institutional endoscopy database identified 518 colonoscopies performed for average-risk screening and completed to the cecum in which the bowel preparation quality was defined as poor, inadequate, or unsatisfactory. After manual review of these colonoscopy reports, 145 were excluded, giving a total of 373 colonoscopies that were included in our analysis. Reasons for exclusion included the
Discussion
Current guidelines do not address the appropriate management of patients found to have inadequate bowel preparation during average-risk screening colonoscopy. Patients with extremely poor bowel preparation usually will have their procedures aborted with instructions to repeat the examination. However, there are a substantial number of patients in whom the bowel preparation is sufficient to allow completion of the examination, but obscuring stool results in visualization that is inadequate to
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See CME section; p. 1243.
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
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