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Meta-Analysis of the Effect of Bowel Preparation on Adenoma Detection: Early Adenomas Affected Stronger than Advanced Adenomas

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  • Michael C Sulz
  • Arne Kröger
  • Meher Prakash
  • Christine N Manser
  • Henriette Heinrich
  • Benjamin Misselwitz

Abstract

Background and Aims: Low-quality bowel preparation reduces efficacy of colonoscopy. We aimed to summarize effects of bowel preparation on detection of adenomas, advanced adenomas and colorectal cancer. Methods: A systematic literature search was performed regarding detection of colonic lesions after normal and low-quality bowel preparation. Reported bowel preparation quality was transformed to the Aronchick scale with its qualities “excellent”, “good”, “fair”, “poor”, and “insufficient” or “optimal” (good/excellent), “suboptimal” (fair/poor/insufficient), “adequate” (good/excellent/fair) and “inadequate” (poor/insufficient). We identified two types of studies: i) Comparative studies, directly comparing lesion detection according to bowel preparation quality, and ii) repeat colonoscopy studies, reporting results of a second colonoscopy after previous low-quality preparation. Results: The detection of early adenomas was reduced with inadequate vs. adequate bowel preparation (Odds Ratio (OR) 0.53, CI: 0.46–0.62, p

Suggested Citation

  • Michael C Sulz & Arne Kröger & Meher Prakash & Christine N Manser & Henriette Heinrich & Benjamin Misselwitz, 2016. "Meta-Analysis of the Effect of Bowel Preparation on Adenoma Detection: Early Adenomas Affected Stronger than Advanced Adenomas," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-17, June.
    • Handle: RePEc:plo:pone00:0154149
    DOI: 10.1371/journal.pone.0154149
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    1. Anna Chaimani & Julian P T Higgins & Dimitris Mavridis & Panagiota Spyridonos & Georgia Salanti, 2013. "Graphical Tools for Network Meta-Analysis in STATA," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-12, October.
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