La hora de ingesta del polietilenglicol es un factor clave en la tolerancia y eficacia de la preparación del colon en individuos de un programa poblacional de cribado de cáncer colorrectal / Timing of polyethylene glycol administration is a key factor in the tolerability and efficacy of colon preparation in colorectal cancer screening

Introducción La calidad y tolerancia de la limpieza anterógrada del colon son elementos clave para el éxito del programa de cribado poblacional de cáncer colorrectal (PPCCR).Objetivos Evaluar la calidad de la limpieza y la tolerancia según la hora de administración del polietilenglicol en individuos del PPCCR. Método Los participantes del PPCCR fueron aleatorizados en 2 grupos: a) grupo control (colonoscopia programada 09:00-12:00h), preparación con polietilenglicol la tarde antes; b) grupo a estudio (colonoscopia programada 12:00-15:00h), preparación con polietilenglicol la mañana de la exploración, con opción de dosis partida. Se valoró la calidad de la limpieza con la escala de Boston y la tolerancia mediante un cuestionario. Resultados Se incluyeron 282 individuos: 134 se prepararon el día anterior y 148 el mismo día, 26 de los cuales realizaron dosis partida. El 95% de los individuos (n=268) presentaron una limpieza adecuada. La calidad de la preparación fue superior en el grupo a estudio (p=0,045). El tiempo entre la finalización de la ingesta y el comienzo de la prueba se correlacionó inversamente con la puntuación de la escala de Boston, (p=0,036; r=−0,125). La tolerancia no se relacionó con el horario de la ingesta (p>0,2). Los individuos del grupo a estudio presentaron peor aceptación del horario que los del grupo control (26 vs. 10%, respectivamente; p=0,001).Conclusiones Los pacientes que se preparan lo más cerca posible de la hora de la exploración presentan mejor calidad de la limpieza sin detrimento en la tolerancia, aunque esta pauta resulta más incómoda (AU)

Introduction The quality and tolerability of antegrade gut lavage bowel preparation are key elements in the success of population-based colorectal cancer screening. Objectives To evaluate cleansing quality and tolerability according to the timing of polyethylene glycol administration in persons undergoing colorectal cancer screening. Method Participants in colorectal cancer screening were randomized to two groups: a) control group (colonoscopy scheduled at 9-12h); preparation with polyethylene glycol on the previous afternoon; b) study group (colonoscopy scheduled at 12-15h): preparation with polyethylene glycol on the morning of the colonoscopy, with the option of a split dose. The quality of cleansing was evaluated with the Boston scale and tolerability through a questionnaire. Results A total of 282 participants were included: preparation was carried out the day before the procedure in 134 and on the same day in 148, of which 26 received a split dose. Cleansing was adequate in 95% (n=268) of the participants. The quality of cleansing was higher in the study group (P=.045). The interval between the end of administration and the beginning of the procedure was inversely correlated with the Boston scale score (P=.036; r=−0.125). Tolerability was unrelated to the time of administration (P>.2). Acceptance of the timing of administration was lower in the study group than in the control group (26% vs 10%, respectively; P=.001).Conclusions Preparation as close as possible to the colonoscopy improves the quality of cleansing with no detrimental effects on tolerability, although this option is less comfortable (AU)

[Timing of polyethylene glycol administration is a key factor in the tolerability and efficacy of colon preparation in colorectal cancer screening]. / La hora de ingesta del polietilenglicol es un factor clave en la tolerancia y eficacia de la preparación del colon en individuos de un programa poblacional de cribado de cáncer colorrectal.

INTRODUCTION: The quality and tolerability of antegrade gut lavage bowel preparation are key elements in the success of population-based colorectal cancer screening. OBJECTIVES: To evaluate cleansing quality and tolerability according to the timing of polyethylene glycol administration in persons undergoing colorectal cancer screening. METHOD: Participants in colorectal cancer screening were randomized to two groups: a) control group (colonoscopy scheduled at 9-12 h); preparation with polyethylene glycol on the previous afternoon; b) study group (colonoscopy scheduled at 12-15 h): preparation with polyethylene glycol on the morning of the colonoscopy, with the option of a split dose. The quality of cleansing was evaluated with the Boston scale and tolerability through a questionnaire. RESULTS: A total of 282 participants were included: preparation was carried out the day before the procedure in 134 and on the same day in 148, of which 26 received a split dose. Cleansing was adequate in 95% (n=268) of the participants. The quality of cleansing was higher in the study group (P=.045). The interval between the end of administration and the beginning of the procedure was inversely correlated with the Boston scale score (P=.036; r=-0.125). Tolerability was unrelated to the time of administration (P>.2). Acceptance of the timing of administration was lower in the study group than in the control group (26% vs 10%, respectively; P=.001). CONCLUSIONS: Preparation as close as possible to the colonoscopy improves the quality of cleansing with no detrimental effects on tolerability, although this option is less comfortable.