Colon Adenoma Clinical Trial
Official title:
Risk Factors of Inadequate Bowel Cleansing in Colon Capsule Endoscopy
The main purpose of the study is to determine risk factors of poor bowel cleansing in patients referred for colon capsule endoscopy (CCE) examination. Patients will be prepared with polyethylene glycol (PEG), and a booster by using oral low volume sodium phosphate (NaP) and sodium-amidotrizoate and meglumine-amidotrizoate (Gastrografin ®) The investigators also will try to design a predictive score of poor bowel cleansing and to validate the Bowel cleansing score designed by Leighton and modified by Spada
As in conventional colonoscopy, colon cleansing is essential to achieve a quality examination
through the colon capsule endoscopy. The CCE also presents additional difficulties due to the
inability to distend the walls of the colon, aspirate liquid and debris and wash. These
reasons make that the colonic preparation should be even more effective when the exploration
is going to be performed by CCE than with the conventional colonoscopy. Using a combination
of PEG, sodium phosphate and bysacodil suppository achieves at least 80% of well-prepared
CCE. The rate of CCE with inadequate preparation according to different studies ranges from
12% to 34% . It has recently been suggested that the addition of a water-soluble contrast
agent such as Gastrografin® commonly used in different radiological tests could improve
cleaning.
Although, predictive factors of poor bowel cleansing in outpatient conventional colonoscopy
are well-known, currently, there are no studies that evaluate the independent predictive
factors of poor colonic preparation in patients who undergo a CCE. The investigation of the
predictive factors of poor colonic preparation in these patients, following the current
recommendations can be of great interest to identify those patients with greater difficulties
in obtaining an acceptable cleaning quality.
The researchers will offer to participate in the study to patients scheduled for CCE who meet
all the inclusion criteria and none of the exclusion criteria. The researchers will explain
the purpose of the study and will ask to sign the informed consent. They will give verbal and
written information on the diet and the bowel cleansing solution to be taken. The bowel
cleansing quality following Spada Bowel Preparation Scale will be assessed by the endoscopist
The aim of this study is to figure out the risk factors of bowel cleansing of inadequate
bowel preparation in patients referred for colon capsule endoscopy.
A maximum of 8 variables in the multivariate analysis will be included. Considering a
percentage of poor preparation of 20%, the inclusion of 350 patients will be necessary. A
maximum of 15% of losses will be considered, so the final sample size will be 403 patients.
A univariate and multivariate analysis will be carried out to determine those factors
associated with a lack of progression from capsule to rectum and accelerated progression. For
the first of these objectives, well prepared colonoscopies but in which the rectum was not
identified (identification of the hemorrhoidal plexus) will be excluded.
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