The Fundación de la Sociedad Española de Endoscopia Digestiva (SEED) has awarded a prize to the study Prevalencia de lesiones perdidas en pacientes con preparación intestinal inadecuada mediante la repetición temprana de una colonoscopia. This multicentre study was led by Dr Marco Antonio Álvarez, member of the Gastrointestinal Oncology, Endoscopy and Surgery research group. Dr Ignasi Puig, coordinator of the Althaia research group, has also participated in the study.
The project, which involved 11 centres in Spain, analyses the percentage and the severity of lesions not detected during colonoscopies due to inadequate preparation. The study won the award for the best clinical research study in endoscopy. The verdict was announced on November 26 during the Congress of the Sociedad Española de Endoscopia Digestiva, held in Malaga.
The importance of intestinal preparation
The study focused on 413 patients with inadequate bowel cleansing in whom colonoscopy was repeated very early, in order to establish whether the inadequate preparation affected the detection of colon lesions during colonoscopy.
Clinical guidelines currently recommend that a colonoscopy be repeated when the cleansing does not reach a sufficient level within a period of one year. Without health education reinforcement, between 20% and 30% of patients do not achieve this adequate bowel cleansing.
The results indicate that insufficient bowel preparation is associated with a lack of detection of advanced lesions: 11% of advanced adenomas, and even 1% of colon cancer. The study also shows that there are two levels of insufficient intestinal preparation. The first is very poor preparation, in which advanced adenomas and cancer are not detected. In these cases, the recommendation is to repeat the colonoscopy as soon as possible. The second is insufficient preparation (poor, but not very poor), in which not all lesions are detected on colonoscopy, but they are not advanced lesions. In this case, it would be possible to maintain the current recommendation to repeat the colonoscopy within a maximum period of one year. The study findings are significant because they may lead to alterations in the current recommendations.