Guidelines for an Optimum Screening Colonoscopy

Abstract

Effective colonoscopy requires a high rate of excellent and good bowel preparations, which can be achieved by split dose or same day dosing. Cecal intubation rates in screening patients should exceed 95%, and experts frequently achieve 99% or more. Cecal intubation should be documented by photographs of the appendiceal orifice and ileocecal valve and notation of landmark visualization. Withdrawal technique must include meticulous inspection of the proximal sides of the folds, clean-up of residual fluid and feces, adequate luminal distension, and adequate withdrawal time. The endoscopist must be familiar with the full spectrum of endoscopic lesions, including flat and depressed lesions and serrated lesions. Optimal screening colonoscopy includes documentation of high quality by adequate adenoma detection rates, cecal intubation rates, and use of appropriate surveillance intervals.

A prospective randomized clinical study evaluating the efficacy and compliance of oral sulfate solution and 2-L ascorbic acid plus polyethylene glycol

“…Adequate bowel preparation is essential for effective colonoscopies [1][2][3][4][5]. Poor bowel preparation results in missed polyps, increased risk of procedural adverse events, and the necessity for repeated examinations [2,5]. An ideal bowel cleansing agent should rapidly empty the fecal material without causing mucosal alteration of the The Korean Journal of Internal Medicine.…”

Oral sulfate solution benefits polyp and adenoma detection during colonoscopy: Meta‐analysis of randomized controlled trials

“…Colonoscopy is considered the most common method in screening, diagnosis, and surveillance of colorectal cancer (CRC) 1,2 . Sufficient bowel preparation is essential to perform high‐quality colonoscopy 3–6 . Nonetheless, suboptimal bowel preparation accounts for approximately one‐quarter of failed colonoscopies 7 .…”

“…1,2 Sufficient bowel preparation is essential to perform high-quality colonoscopy. [3][4][5][6] Nonetheless, suboptimal bowel preparation accounts for approximately one-quarter of failed colonoscopies. 7 Insufficient bowel preparation can reduce the detection rate of polyp and adenoma, 8 prolongs procedural duration, 9 and increases the risk of colonoscopy-associated complications, 10 the need for a repeated colonoscopy, 11 and medical expenditures.…”