The aim of this multisite study (N = 412) was to identify which colon-cleansing preparations used before colonoscopy work best with specific patient populations. A comparative, descriptive approach was used to (1) describe bowel-cleansing preparations being used across the United States, (2) compare their cleansing effectiveness and tolerability, and (3) compare their effectiveness in patients with various health characteristics. A descriptive demographic data form adapted from the Society of Gastroenterology Nurses and Associates Minimum Data Set was used to collect baseline information, identify preprocedure instructions, and describe compliance with preparations. Subjects completed an 11-item subject experience with the bowel-cleansing form before their colonoscopy. A colon cleanliness scale was completed during the colonoscopy to evaluate the effectiveness of the preparation. The preparations revealed a "good" to "excellent" rating and there was no statistical difference in the cleansing effectiveness of the preparations. Subjects experienced a variety of discomforts. Future studies that involve the pooling of data from multiple sites in different geographical areas may provide more precise criteria for the selection of colon-cleansing preparation for specific patients and increase the cultural diversity of the sample.

Background: The role of Y90 in surgical algorithm for treatment of metastatic colorectal cancer (mCRC) to the liver is not well defined. In fact, treatment algorithms allow for use of Y90 at many points in the time line of the mCRC patient. The goal of this study was to define a role of Y90 in surgical algorithms. Methods: A group of thought leaders from HPB, surgical oncology and transplant backgrounds were asked to participate in a delphi analysis framework to look at the data on Y90 in liver mCRC patients. Through this process, a series of algorithms were developed and vetted with a greater group of similar liver surgeons. Results: Using the methodology of literature-driven analysis, the group came up with a framework of defining mCRC to the liver into defined categories that matched other tumor sites: resectable, borderline resectable and unresectable. The role of Y90 was to move patients to the left of each algorithm and this was the impetus to drive a surgically driven set of pathways that could be used by all liver surgeons. Conclusion: Through a data-driven mechanism, a new three group categorization of mCRC patients into resectable, borderline resectable and unresectable was developed. The role of Y90 was defined in each of these groups with the aim to move towards being surgically treatable. This framework is a novel way to look at mCRC patients with liver surgery being the desired end-point.