Ultrasonographic evaluation of gastric emptying and correlation of bowel preparation quality with different waiting times in patients undergoing colonoscopy with sedation: A randomized controlled clinical trial.

STUDY

OBJECTIVE

Quality of bowel preparation correlates with the time interval between its completion and colonoscopy in patients receiving colonoscopy. Previous studies focused primarily on awake patients, neglecting the risk of regurgitation and aspiration in those receiving sedation. We investigated the relationship between gastric emptying time, colonoscopy waiting time, and bowel preparation quality in patients undergoing colonoscopy with sedation.

DESIGN

A prospective, randomized trial.

SETTING

Endoscopy center.

PATIENTS: 134 patients receiving colonoscopy with sedation.

INTERVENTIONS: Gastric ultrasound assessment was initiated 2 or 4 h after completing the 3 L split-dose oral sulfate solution (OSS), followed by colonoscopy within 2-4 h (Group A) or 4-6 h (Group B) after confirming gastric emptying.

MEASUREMENTS: The primary outcomes were full stomach rate at various timepoints and bowel preparation quality. Secondary outcomes included colonoscopy waiting time, operation time, terminal ileal intubation rate, polyp and adenoma detection rate, and overall satisfaction.

MAIN

RESULTS

Gastric emptying was confirmed at 2 or 4 h after bowel preparation in all patients. The bowel preparation score was significantly higher in Group A than in Group B (7.0 [6.0-8.0] vs 6.0 [5.0-7.0], P < 0.001), and patient satisfaction was also higher (10.0 [8.0-10.0] vs 8.0 [7.0-9.0], P < 0.001).

CONCLUSIONS

Performing colonoscopy 2 h after 3 L split-dose OSS intake does not increase the risk of intraoperative regurgitation or aspiration as assessed by ultrasound in this selected, low-risk population. Colonoscopy performed within 2-4 h after bowel preparation completion yields superior bowel preparation quality compared to 4-6 h.