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Clinical Trial
. 2019 Jan;60(1):73-78.
doi: 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

Bun Kim  1   2 , Byung Chang Kim  1   3 , Jeongseon Kim  4 , Hyun Jin Oh  2 , Kum Hei Ryu  2 , Bum Joon Park  2 , Dae Kyung Sohn  1   2 , Chang Won Hong  1   2 , Kyung Su Han  1   2
Affiliations
Clinical Trial

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

Bun Kim et al. Yonsei Med J. 2019 Jan.

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.

Keywords: Postoperative period; bowel preparation; cohort study; colonoscopy.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Inclusion and exclusion process.
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