AN INTRACOLONOSCOPY BOWEL CLEANSING SYSTEM FOR HARD-TO-PREPARE PATIENTS – A PROSPECTIVE MULTICENTER STUDY

Aims Adequate bowel preparation (BP) is essential for the efficacy and safety of colonoscopy. However, inadequate BP is reported in approximately 20% of colonoscopies, despite intensified regimes. Therefore, we hypothesized that an intraprocedural bowel cleansing system (Pure-Vu System, MotusGI) could fill this gap in BP strategies for hard-to-prepare patients. This study aims to assess the feasibility of the Pure-Vu in patients with a history of poor BP for colonoscopy.

Methods This ongoing international, multicenter study will include 44 patients with a history of inadequate BP in the last 2 years and undergoing screening/surveillance colonoscopy. Enrollment will be finished in February 2022. All patients received a limited BP, consisting of 300mL split-dose sodium picosulfate magnesium citrate and a 2-day low-fiber diet. Additional cleansing was done with the Pure-Vu. Primary outcome was bowel cleanliness using the Boston Bowel Preparation Scale (BBPS). Secondary outcomes included cecal intubation rate (CIR).

Results So far, 18 patients have been enrolled. Median BBPS before and after cleansing with the Pure-vu system was 1-2-2, and 3-3-3, respectively (P<0.001). CIR was 88.9%. Reasons for incomplete colonoscopy were looping (n=1) and a relative stricture (n=1), possibly due to the added scope-diameter.

Conclusions The Pure-Vu could be an important tool to achieve compliance to surveillance intervals since patients with a history of poor BP typically undergo extensive preparation regimes and frequent colonoscopies due to poor visualization quality. Since these patients may have complicated anatomy (i.e., surgical scarring, diverticulosis), these factors should be considered to avoid incomplete procedures.

Publication History

Article published online:
14 April 2022