The impact of procedural sequence on the quality of bowel preparation in patients with propofol sedation for same-day bidirectional endoscopy / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the impact of sequence on the quality of bowel preparation in patients with anesthesia for same-day sequential bidirectional endoscopy and propose the optimal procedural sequence.Methods Single center blinded randomized observational study.Sixty-five patients were randomized to either the gastroscopy-first group or the colonoscopy-first group.Bowel cleanliness according to Boston bowel preparation scale (BBPS) scores were evaluated,also done the propofol dosage,caecal intubation time,procedure duration and complications.Results The BBPS score of entire colon showed no difference (6.72 ± 1.34 vs.6.89 ± 1.50,P =0.638),but the BBPS of ileal-cecum portion was higher in the colonoscopy-first group (1.21 ±0.54 vs.1.55 ±0.73,P =0.035).The total procedure time,propofol dosage and complications were similar between the two groups.Conclusion The bowel cleanliness of ileal-cecum portion in colonoscopy-first group is better than that of gastroscopy-first group during sequential bidirectional endoscopy in patients with propofol sedation.We propose colonoscopy first in patients with suspicious ileal-cecum lesion.