Yonsei Med J.  2019 Jan;60(1):73-78. 10.3349/ymj.2019.60.1.73.

Quality of Bowel Preparation for Colonoscopy in Patients with a History of Abdomino-Pelvic Surgery: Retrospective Cohort Study

• Kim B
• Kim BC
• Kim J
• Oh HJ
• Ryu KH
• Park BJ
• Sohn DK
• Hong CW
• Han KS

• KMID: 2428280
• DOI: http://doi.org/10.3349/ymj.2019.60.1.73

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 AP surgery 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 screening or surveillance colonoscopy between June 2007 and December 2014 were included. Personal data were collected by reviewing patient medical records. Bowel preparation quality was assessed using the Aronchick scale and was categorized as satisfactory for 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 satisfactory bowel preparations was 70.7%. In multivariate analysis, unsatisfactory bowel preparation was related to gastric/small intestinal surgery (odds ratio=1.764, 95% confidence interval=1.230-2.532, p=0.002). However, the other surgery types did not affect bowel preparation 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 patients with a history of gastric/small intestinal surgery to determine appropriate methods for adequate bowel preparation is mandatory.

Keyword

Postoperative period; colonoscopy; bowel preparation; cohort study

MeSH Terms

Body Mass Index
Cesarean Section
Cohort Studies*
Colonoscopy*
Colorectal Surgery
Female
Humans
Mass Screening
Medical Records
Multivariate Analysis
Postoperative Period
Pregnancy
Retrospective Studies*
Risk Factors
Smoke
Smoking
Smoke

Figure

• 

  Fig. 1 Inclusion and exclusion process.

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