Mather Hospital, Northwell Health Port Jefferson, NY
Justin Chuang, MD, Eugene Licht, MD, Ramona Rajapakse, MD Mather Hospital, Northwell Health, Port Jefferson, NY
Introduction: Prior studies have shown that Split Dose preparation increases detection of adenomas but data is limited due to the paucity of studies. We therefore performed an updated systematic review and meta-analysis to assess whether using a Split Dose bowel preparation improves detection of adenomas when compared to single dose Same Day and Day Prior preparations.
Methods: We searched Medline, EMBASE, Cochrane database from inception through November 2023 to identify prospective and randomized control studies that provided data on adenoma detection rate using Same Day/Day Prior preparation compared with Split Dose regimens. The primary outcome of interest was to evaluate adenoma detection rates based on the specific bowel regimens used.
Results: A total of sixteen studies fit our inclusion criteria. 5072 patients were included in the studies. These studies were pooled using Cochrane's software Review Manager (RevMan) 5.3 Tool and a forest plot was generated for each respective comparison [Figure A/Figure B]. Comparing Split Dose to Day Prior preparations, there was an increased detection rate of adenomas (Odds Ratio [1.52] 95% CI [1.22–1.88] p-Value [.0001]). Pooled estimates from 9 trials (2,137 participants) evaluating Split Dose vs Same Day bowel preparations yielded no evidence of statistical difference (Odds Ratio [.97] 95% CI [.8-1.17] P-value [.75])
Discussion: Pooled analysis failed to show a statistically significant difference in adenoma detection rate between Same Day and Split Dose preparation but showed that Split Dose preparations compared with Day Prior preparations have a higher adenoma detection rate. This finding indicates that timing of bowel preparation closer to the procedure is the key factor in improving adenoma detection rates and further supports the use of Same Day or Split Dose bowel preparations rather than Day Prior bowel regimens.
Figure: Figure A. Adenoma detection rate with day prior prep versus split dose prep Figure B. Adenoma detection rate with same day prep compared with split dose prep
Disclosures:
Justin Chuang indicated no relevant financial relationships.
Eugene Licht indicated no relevant financial relationships.
Ramona Rajapakse indicated no relevant financial relationships.
Justin Chuang, MD, Eugene Licht, MD, Ramona Rajapakse, MD. P0444 - Same Day and Split Dose Bowel Preparations Have Similar Adenoma Detection Rates: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
