Endoscopy 2015; 47(10): 917-924
DOI: 10.1055/s-0034-1391987
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Split dosing with a low-volume preparation is not inferior to split dosing with a high-volume preparation for bowel cleansing in patients with a history of colorectal resection: a randomized trial

Alessandro Mussetto
1  Division of Gastroenterology, S. Maria delle Croci Hospital, Ravenna, Italy
,
Leonardo Frazzoni
2  Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
,
Silvia Paggi
3  Division of Endoscopy, Valduce Hospital, Como, Italy
,
Silvia Dari
1  Division of Gastroenterology, S. Maria delle Croci Hospital, Ravenna, Italy
,
Liboria Laterza
2  Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
,
Franco Radaelli
3  Division of Endoscopy, Valduce Hospital, Como, Italy
,
Cesare Hassan
4  Digestive Endoscopy Unit, Catholic University, Rome, Italy
,
Omero Triossi
1  Division of Gastroenterology, S. Maria delle Croci Hospital, Ravenna, Italy
,
Lorenzo Fuccio
2  Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
› Author Affiliations
Further Information

Publication History

submitted 07 November 2014

accepted after revision 19 February 2015

Publication Date:
24 April 2015 (online)

Background and study aim: The study compared the efficacy of bowel cleansing using a low-volume mixed preparation (15 mg bisacodyl plus 2 L polyethylene glycol [PEG] solution) versus a standard high-volume preparation (4 L PEG) in patients with previous colorectal resection.

Patients and methods: A total of 120 patients with prior colorectal resection for cancer undergoing surveillance colonoscopy were randomized to receive either a split-dose low-volume (n = 60) or high-volume (n = 60) preparation for bowel cleansing. The quality of bowel preparation, rated according to a modified Ottawa Bowel Preparation scale (mOBPS), represented the primary outcome measure. Tolerability, safety, and lesion detection rates were secondary outcomes.

Results: No significant difference was observed between the low-volume and high-volume preparations in achievement of adequate cleansing (i. e. mOBPS ≤ 4; low-volume vs. high-volume group, 85.0 % vs. 81.7 %, P = 0.624). The low-volume preparation showed a higher success rate for cleansing of the right colon (P = 0.025); better tolerability in terms of intake of the whole amount of the preparation (P < 0.001) was also observed. According to the logistic regression analysis, the only predictors of unsuccessful cleansing were previous left colectomy (P = 0.012) and a longer elapsed time since the intervention (P = 0.034). Lesion detection rates were comparable between the groups. No serious adverse events were reported.

Conclusion: A low-volume preparation is not inferior to a high-volume preparation for adequate bowel cleansing in patients with prior colorectal resection for cancer. If larger, multicenter, prospective studies confirm our findings, a low-volume preparation will represent a more tolerable option for such patients.

Trial registration number: ClinicalTrial.gov identifier NCT01887158.

Appendix e1 and e2 and Table e5