P0276 - Effects of Bowel Preparation Quality on Detection Rates of Sessile Serrated Polyps

Neil R. Jariwalla, MD¹, Daniel Kim, MD², William Karnes, MD^3
1University of California Irvine Medical Center, Orange, CA; ²H. H. Chao Comprehensive Digestive Disease Center, University of California Irvine, Orange, CA; ³Digestive Health Institute, University of California Irvine Medical Center, Irvine, CA

Introduction: The effects of bowel preparation quality on the adenoma detection rate (ADR) have been well established in the literature. However, the effect of bowel preparation quality on the detection rate of sessile serrated polyps (SSPs), specifically, is not as well studied. We seek to determine the effect of varying bowel preparation scores on the detection rate of SSPs.

Methods: A retrospective review was conducted of all colonoscopies performed at our tertiary care academic medical center from 2012-2018. The Boston Bowel Preparation Scale (BBPS) was used to assess quality of bowel preparation in the right, middle, and left segments of the colon (scale 0-3), with scores 2+ qualifying as adequate. SSP detection rates (SDR) were analyzed both overall and per bowel segment. Statistical analysis was performed using chi-square and two-sample t test.

Results: A total of 10,949 colonoscopies were included in the statistical analysis. The overall SDR was 9.4% and the mean number of SSPs detected per procedure was 0.15. The average SDR was found to be 10.1% for overall BBPS score 7-9 (n=8225, 95% CI 9.4-10.6, p=0.006), 7.5% for overall BBPS score 4-6 (n=2301, 95% CI 5.9-8.1, p=0.01), and 4.5% for overall BBPS score 0-3 (n=423, 95% CI 2.8-7.2, p=0.02). When BBPS score was noted to be inadequate (< 2) in any bowel segment, average SDR was 6% (n=871, 95% CI 4.4-7.6, p=0.016) compared to 10% when BBPS score was adequate in every segment (n=10078, 95% CI 9.4-10.6, p=0.006). The influence of inadequate preparation on SDR was not significantly affected by which segment(s) were inadequate.

Discussion: Overall SDR was noted to be 9.4%. There was a statistically significant improvement observed in average SDR with higher quality overall bowel preparation. Inadequacy of bowel preparation in any one bowel segment resulted in a statistically significant decrease in average SDR. This decrease was not impacted by which specific segment(s) had inadequate preparation.


Disclosures:


Neil R. Jariwalla, MD¹, Daniel Kim, MD², William Karnes, MD³. P0276 - Effects of Bowel Preparation Quality on Detection Rates of Sessile Serrated Polyps, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.