Quality of Bowel Preparation for Colonoscopy in Patients with a History of Abdomino-Pelvic Surgery: Retrospective Cohort Study
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Purpose: Prior abdomino-pelvic (AP) surgery makes colonoscopy difficult and can affect bowel preparation quality. However,bowel preparation quality has been found to vary according to prior AP surgery type. We examined the relationship of prior APsurgery type with bowel preparation quality in a large-scale retrospective cohort. Materials and Methods: In the health screening cohort of the National Cancer Center, 12881 participants who underwent screeningor surveillance colonoscopy between June 2007 and December 2014 were included. Personal data were collected by reviewingpatient medical records. Bowel preparation quality was assessed using the Aronchick scale and was categorized as satisfactoryfor excellent to good bowel preparation or unsatisfactory for fair to inadequate bowel preparation. Results: A total of 1557 (12.1%) participants had a history of AP surgery. The surgery types were colorectal surgery (n=44), gastric/small intestinal surgery (n=125), appendectomy/peritoneum/laparotomy (n=476), cesarean section (n=278), uterus/ovarian surgery(n=317), kidney/bladder/prostate surgery (n=19), or liver/pancreatobiliary surgery (n=96). The proportion of satisfactorybowel preparations was 70.7%. In multivariate analysis, unsatisfactory bowel preparation was related to gastric/small intestinalsurgery (odds ratio=1.764, 95% confidence interval=1.230–2.532, p=0.002). However, the other surgery types did not affect bowelpreparation quality. Current smoking, diabetes, and high body mass index were risk factors of unacceptable bowel preparation. Conclusion: Only gastric/small intestinal surgery was a potential risk factor for poor bowel preparation. Further research on patientswith a history of gastric/small intestinal surgery to determine appropriate methods for adequate bowel preparation is mandatory.
Abstract
Purpose: Prior abdomino-pelvic (AP) surgery makes colonoscopy difficult and can affect bowel preparation quality. However,bowel preparation quality has been found to vary according to prior AP surgery type. We examined the relationship of prior APsurgery type with bowel preparation quality in a large-scale retrospective cohort. Materials and Methods: In the health screening cohort of the National Cancer Center, 12881 participants who underwent screeningor surveillance colonoscopy between June 2007 and December 2014 were included. Personal data were collected by reviewingpatient medical records. Bowel preparation quality was assessed using the Aronchick scale and was categorized as satisfactoryfor excellent to good bowel preparation or unsatisfactory for fair to inadequate bowel preparation. Results: A total of 1557 (12.1%) participants had a history of AP surgery. The surgery types were colorectal surgery (n=44), gastric/small intestinal surgery (n=125), appendectomy/peritoneum/laparotomy (n=476), cesarean section (n=278), uterus/ovarian surgery(n=317), kidney/bladder/prostate surgery (n=19), or liver/pancreatobiliary surgery (n=96). The proportion of satisfactorybowel preparations was 70.7%. In multivariate analysis, unsatisfactory bowel preparation was related to gastric/small intestinalsurgery (odds ratio=1.764, 95% confidence interval=1.230–2.532, p=0.002). However, the other surgery types did not affect bowelpreparation quality. Current smoking, diabetes, and high body mass index were risk factors of unacceptable bowel preparation. Conclusion: Only gastric/small intestinal surgery was a potential risk factor for poor bowel preparation. Further research on patientswith a history of gastric/small intestinal surgery to determine appropriate methods for adequate bowel preparation is mandatory.
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