Background: Colonoscopies are carried out for a range of reasons including for the detection of colon cancer and investigation of abdominal and bowel related symptoms. Inadequate preparation can increase the burden of repeat procedures.Methods: A systematic review aimed to identify the rate of repeat colonoscopies due to inadequate bowel preparation in France, Germany, Italy, Spain and the United Kingdom. The information obtained populated a decision analytic model to estimate the cost implications of inadequate bowel cleansing in the same five countries. The model explored scenarios by comparing one and two-litre polyethylene glycol-based bowel preparation.Results: The systematic review identified 14 eligible studies reporting on the proportion of patients with inadequate bowel cleansing indicated for a repeat procedure. Data were available for Italy (27.5%-35.9%), Spain (63%) and the UK (24.5%) only. The decision analytic model demonstrates that improving the proportion of adequate bowel cleansing at first colonoscopy is likely to generate cost savings.Conclusions: Based on the available evidence, increasing the proportion of people who have adequate bowel cleansing at index colonoscopy will likely have financial benefits in Italy, Spain and the UK. A paucity of data, for France and Germany, limits the robustness of conclusions in these countries.

中文翻译：

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在五个欧洲国家中，由于肠道清洗不充分而导致的重复结肠镜检查的系统评价和成本分析。

背景：进行结肠镜检查的原因很多，包括结肠癌的检测以及腹部和肠相关症状的调查。方法准备：在法国，德国，意大利，西班牙和英国，由于肠道准备不足而导致重复结肠镜检查的比率很高，因此准备工作不充分会增加重复手术的负担。所获得的信息构成了一个决策分析模型，以估计在这五个国家中肠道清洁不足的成本影响。该模型通过比较一升和两升基于聚乙二醇的肠准备物探索了各种情况。结果：系统评价确定了14项合格研究，报告了肠清洗不足的患者的比例，需要进行重复手术。仅提供意大利（27.5％-35.9％），西班牙（63％）和英国（24.5％）的数据。决策分析模型表明，在初次结肠镜检查时提高肠道清洁的比例很可能会节省成本。结论：根据现有证据，增加在结肠镜检查时进行足够肠道清洁的人的比例可能会带来经济利益。意大利，西班牙和英国。法国和德国的数据匮乏，限制了这些国家结论的可靠性。在意大利，西班牙和英国，增加在结肠镜检查中进行充分肠道清洁的人的比例可能会带来经济利益。法国和德国的数据匮乏，限制了这些国家结论的可靠性。在意大利，西班牙和英国，增加在结肠镜检查中进行充分肠道清洁的人的比例可能会带来经济利益。法国和德国的数据匮乏，限制了这些国家结论的可靠性。