Background and Aims

Only scant data describe the practice of canceling colonoscopies before colonoscope insertion for presumed inadequate bowel preparation (PIBP). We sought to better understand the ramifications of such cancellations and to characterize the nationwide practice of cancellations for PIBP.

Methods

We determined the frequency of colonoscopies canceled for PIBP at our institution, assessing practice variation and whether patients who were canceled for PIBP completed colonoscopy or fecal immunohistochemical testing within 6 months. We also surveyed gastroenterology program directors to determine whether canceling colonoscopies for PIBP is commonly permitted and if such cancellations are included in calculations of bowel preparation adequacy rates.

Results

Three percent of patients were canceled because of PIBP at our institution, with significant provider practice variability in cancellation rates. Only 67% of patients whose cases were canceled for PIBP completed colonoscopy or fecal immunohistochemical testing within 6 months. The ability of an endoscopist to cancel a colonoscopy for PIBP was reported by 97% of survey respondents. Such cases are frequently not included in calculations of bowel preparation adequacy rates.

Conclusions

The ability to cancel colonoscopies because of PIBP is near ubiquitous, but such cases are not uniformly included in calculations of bowel preparation adequacy rates. Variation in provider practice, and resulting impact on patient care, suggests a need for standardized protocols. Colonoscopies canceled for PIBP should be included in calculations of bowel preparation adequacy rates.

中文翻译：

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评估因肠准备不足而取消结肠镜检查的做法。

背景和目标

只有很少的数据描述了在肠镜插入之前取消结肠镜检查的做法，因为这可能是肠道准备不足（PIBP）的原因。我们试图更好地理解此类取消的后果，并描述PIBP在全国范围内取消的惯例。

方法

我们确定了在我们机构中因PIBP取消结肠镜检查的频率，评估实践差异以及因PIBP而取消的患者是否在6个月内完成了结肠镜检查或粪便免疫组化测试。我们还对胃肠病学计划主管进行了调查，以确定是否通常允许取消PIBP的结肠镜检查，以及是否在肠准备充足率的计算中包括这种取消。

结果

在我们的机构中​​，有3％的患者因PIBP而被取消，提供者的实际做法在取消率方面存在很大差异。在因PIBP而被取消病例的患者中，只有67％的患者在6个月内完成了结肠镜检查或粪便免疫组织化学检查。97％的调查受访者报告了内镜医师取消PIBP结肠镜检查的能力。这种情况通常不包括在肠道准备充足率的计算中。

结论

由于PIBP而取消结肠镜检查的能力几乎是普遍存在的，但是在肠准备充足率的计算中并未统一包括这种情况。提供者实践的变化以及对患者护理的影响表明需要标准化协议。PIPI取消的结肠镜检查应包括在肠道准备充足率的计算中。