gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2023-22-2-57-63gnck-1801Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESРоль режима питания при подготовке толстой кишки к колоноскопии. Проспективное обсервационное исследованиеThe role of diet in bowel cleansing for colonoscopy (results of prospective observation study). Prospective observations studyhttps://orcid.org/0000-0002-1979-5224ГаляевА. В.GalyaevA. V.

ул. Саляма Адиля, д. 2, г. Москва, 123423, Россия

Salyama Adilya st., 2, Moscow, 123423, Russia

https://orcid.org/0000-0001-5743-1344СуровегинЕ. С.SuroveginE. S.

ул. Саляма Адиля, д. 2, г. Москва, 123423, Россия

Salyama Adilya st., 2, Moscow, 123423, Russia

surovegin.e@gmail.comhttps://orcid.org/0000-0001-5848-4050ЛикутовА. А.LikutovA. A.

ул. Саляма Адиля, д. 2, г. Москва, 123423, Россия

ул. Баррикадная, д. 2/1, стр. 1, г. Москва, 125993, Россия

Salyama Adilya st., 2, Moscow, 123423, Russia

Barrikadnaya st., 2/1-1, Moscow, 125993, Russia

https://orcid.org/0000-0001-9780-7916СушковО. И.SushkovO. I.

ул. Саляма Адиля, д. 2, г. Москва, 123423, Россия

Salyama Adilya st., 2, Moscow, 123423, Russia

https://orcid.org/0000-0003-4872-4481ВагановЮ. Е.VaganovYu. E.

ул. Саляма Адиля, д. 2, г. Москва, 123423, Россия

Salyama Adilya st., 2, Moscow, 123423, Russia

https://orcid.org/0000-0001-6427-9790ВосканянА. С.VoskanyanA. S.

ул. Саляма Адиля, д. 2, г. Москва, 123423, Россия

Salyama Adilya st., 2, Moscow, 123423, Russia

https://orcid.org/0000-0002-6983-9862МеркуловаЕ. С.MerkulovaE. S.

ул. Саляма Адиля, д. 2, г. Москва, 123423, Россия

Salyama Adilya st., 2, Moscow, 123423, Russia

ФГБУ «НМИЦ колопроктологии имени А.Н. Рыжих» Минздрава РоссииРоссияRyzhikh National Medical Research Center of ColoproctologyRussian FederationФГБУ «НМИЦ колопроктологии имени А.Н. Рыжих» Минздрава России; ФГБОУ ДПО РМАНПО Минздрава РоссииРоссияRyzhikh National Medical Research Center of Coloproctology; Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of RussiaRussian Federation2023210620232225763Copyright © Галяев А.В., Суровегин Е.С., Ликутов А.А., Сушков О.И., Ваганов Ю.Е., Восканян А.С., Меркулова Е.С., 20232023Галяев А.В., Суровегин Е.С., Ликутов А.А., Сушков О.И., Ваганов Ю.Е., Восканян А.С., Меркулова Е.С.Galyaev A.V., Surovegin E.S., Likutov A.A., Sushkov O.I., Vaganov Y.E., Voskanyan A.S., Merkulova E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1801ЦЕЛЬ ИССЛЕДОВАНИЯ

ЦЕЛЬ ИССЛЕДОВАНИЯ: оценка влияния соблюдения режима питания при подготовке к колоноскопии на качество эндоскопического исследования.

ПАЦИЕНТЫ И МЕТОДЫ

ПАЦИЕНТЫ И МЕТОДЫ: в проспективное обсервационное исследование включено 1000 пациентов, которым было запланировано проведение диагностической колоноскопии. Качество подготовки кишечника оценивалось с помощью Бостонской шкалы. Проводилось изучение состояния толстой кишки, в случае обнаружения новообразований проводилась их эндоскопическая оценка. На основании оптической верификации опухолей рассчитывались индексы выявленных аденом и полипов (ADR и PDR).

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ: медиана качества подготовки толстой кишки, оцениваемая по Бостонской шкале, составила 6 (6;8) баллов. Не соблюдали рекомендованную диету 198 (19,8%) обследуемых. Плохая подготовка, не позволившая провести полноценный осмотр толстой кишки, была констатирована у 91 пациента, что составило 9,1% всех диагностических процедур. Показатель ADR составил 37,4%, PDR — 43,4%. При проведении логистического регрессионного анализа предикторов неадекватной подготовки кишечника обнаружено, что единственным фактором, значимо негативно влияющим на ее качество, явилось несоблюдение диеты.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ: неудовлетворительная подготовка кишечника констатирована у 9,1% пациентов. Основным фактором, ухудшающим ее качество, оказалось несоблюдение перед эндоскопической процедурой назначенной диеты.

AIM

AIM: to evaluate the impact of dietary compliance in bowel cleansing for colonoscopy on the quality of the procedure.

PATIENTS AND METHODS

PATIENTS AND METHODS: one thousand patients who scheduled for diagnostic colonoscopy were included in the prospective observation study. The quality of bowel preparation was assessed using the Boston scale. Neoplasms were detected and endoscopically evaluated. The optical verification of tumors was used to calculate the indicators of identified adenomas and polyps (ADR and PDR).

RESULTS

RESULTS: the quality of bowel cleansing by the Boston Scale was 6 (6; 8) points. One hundred eight (19.8%) patients did not follow the recommended diet. Poor preparation, which did not allow a total colonoscopy was found in 91 (9,1%) cases. The ADR was 37.4%, PDR — 43.4%. Logistic regression analysis showed that the noncompliance for diet recommendation was the only one significantly negative factor associated whit inadequate bowel cleansing.

CONCLUSION

CONCLUSION: the leading factor worsening the quality of bowel cleansing was non-compliance with the prescribed diet before the colonoscopy.

подготовка к колоноскопииподготовка толстой кишкирежим питанияколопроктологияPDRcolonoscopy preparationcolon preparationdietcoloproctologyReferencesDoubeni CA, Corley DA, Quinn VP, et al. Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: A large community-based study. Gut. 2018;2(67):291–298.Doubeni CA, Corley DA, Quinn VP, et al. Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: A large community-based study. Gut. 2018;2(67):291–298.Baker FA, Mari A, Nafrin S, et al. Predictors and colonoscopy outcomes of inadequate bowel cleansing: A 10-year experience in 28,725 patients. Annals of Gastroenterology. 2019;5(32):457–462.Baker FA, Mari A, Nafrin S, et al. Predictors and colonoscopy outcomes of inadequate bowel cleansing: A 10-year experience in 28,725 patients. Annals of Gastroenterology. 2019;5(32):457–462.Wexner SD, Beck DE, Baron TH, et al. A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Gastrointestinal endoscopy. 2006;7(63):894–909.Wexner SD, Beck DE, Baron TH, et al. A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Gastrointestinal endoscopy. 2006;7(63):894–909.Alawi SA, Dhahab HA, Salmi I. Al Split dose bowel preparation before colonoscopy of PEG (Nulytely) in comparison to routine single dose bowel preparation. Saudi Journal of Gastroenterology. 2021;4(27):234–239.Alawi SA, Dhahab HA, Salmi I. Al Split dose bowel preparation before colonoscopy of PEG (Nulytely) in comparison to routine single dose bowel preparation. Saudi Journal of Gastroenterology. 2021;4(27):234–239.Ikematsu H, Matsuda T, Emura F, et al. Efficacy of Capillary Pattern Type IIIA/IIIB by Magnifying Narrow Band Imaging for Estimating Depth of Invasion of Early Colorectal Neoplasms. BMC Gastroenterol. 2010; p.10-33.Ikematsu H, Matsuda T, Emura F, et al. Efficacy of Capillary Pattern Type IIIA/IIIB by Magnifying Narrow Band Imaging for Estimating Depth of Invasion of Early Colorectal Neoplasms. BMC Gastroenterol. 2010; p. 10–33.Denis B, Sauleau EA, Gendre I, et al. Measurement of adenoma detection and discrimination during colonoscopy in routine practice: An exploratory study. Gastrointestinal Endoscopy. 2011;6(74):1325–1336.Denis B, Sauleau EA, Gendre I, et al. Measurement of adenoma detection and discrimination during colonoscopy in routine practice: An exploratory study. Gastrointestinal Endoscopy. 2011;6(74):1325–1336.Lai EJ, Calderwood AH, Doros G, et al. The Boston Bowel Preparation Scale: A valid and reliable instrument for colonoscopyoriented research. Gastrointest Endoscopy. 2009; 69(3 Pt 2): 620–625. doi: 10.1016/j.gie.2008.05.057Lai EJ, Calderwood AH, Doros G, et al. The Boston Bowel Preparation Scale: A valid and reliable instrument for colonoscopyoriented research. Gastrointest Endoscopy. 2009; 69(3 Pt 2): 620–625. doi: 10.1016/j.gie.2008.05.057Wada Y, Kudo S, Kashida H, et al. Diagnosis of colorectal lesions with the magnifying narrow-band imaging system. Gastrointest Endosc. 2009;70:522–31.Wada Y, Kudo S, Kashida H, et al. Diagnosis of colorectal lesions with the magnifying narrow-band imaging system. Gastrointest Endosc. 2009;70:522–31.Alvarez-Gonzalez MA, Pantaleon MA, Flores-Le Roux JA, et al. Randomized clinical trial: A normocaloric low-fiber diet the day before colonoscopy is the most effective approach to bowel preparation in colorectal cancer screening colonoscopy. Diseases of the Colon and Rectum. 2019;4(62):491–497.Alvarez-Gonzalez MA, Pantaleon MA, Flores-Le Roux JA, et al. Randomized clinical trial: A normocaloric low-fiber diet the day before colonoscopy is the most effective approach to bowel preparation in colorectal cancer screening colonoscopy. Diseases of the Colon and Rectum. 2019;4(62):491–497.Mahmood S, Farooqui SM, Madhoun MF. Predictors of inadequate bowel preparation for colonoscopy: A systematic review and metaanalysis. European Journal of Gastroenterology and Hepatology. 2018;8(30):819–826.Mahmood S, Farooqui SM, Madhoun MF. Predictors of inadequate bowel preparation for colonoscopy: A systematic review and metaanalysis. European Journal of Gastroenterology and Hepatology. 2018;8(30):819–826.Chou C, Chang C, Chang C, et al. Controlled Dietary Restriction With a Prepackaged Low-Residue Diet Before Colonoscopy Offers Better-Quality Bowel Cleansing and Allows the Use of a Smaller Volume of Purgatives: A Randomized Multicenter Trial. Dis Colon Rectum. 2016;59:975–983.Chou C, Chang C, Chang C, et al. Controlled Dietary Restriction With a Prepackaged Low-Residue Diet Before Colonoscopy Offers Better-Quality Bowel Cleansing and Allows the Use of a Smaller Volume of Purgatives: A Randomized Multicenter Trial. Dis Colon Rectum. 2016;59:975–983.Веселов В.В., Костенко Н.В., Васильченко А.В. Сравнительный анализ методов подготовки толстой кишки к колоноскопии. Колопроктология. 2010;4(34):8–12.Veselov V.V., Kostenko N.V., Vasilchenko A.V. Comparative analysis of methods for preparing the colon for colonoscopy. Koloproctologia. 2010;4(34):8–12. (In Russ.).Веселов В.В., Федоров Е.Д., Иванова Е.В. и соавт. Клинические рекомендации по подготовке пациентов к эндоскопическому исследованию толстой кишки. М.; 2017.Veselov V.V., Fedorov E.D., Ivanova E.V., et al. Clinical guidelines preparing patients for endoscopic examination of the colon. М.; 2017. (In Russ.).Wu RJi, Wen Y, Cheng A, et al. Systematic Review and MetaAnalysis of Low-Residue Diet Versus Clear Liquid Diet: Which Is Better for Bowel Preparation before Colonoscopy? Gastroenterology Nursing. 2021;5(44):341–352.Wu RJi, Wen Y, Cheng A, et al. Systematic Review and Meta- Analysis of Low-Residue Diet Versus Clear Liquid Diet: Which Is Better for Bowel Preparation before Colonoscopy? Gastroenterology Nursing. 2021;5(44):341–352.Zhang Y, Ding C, Li J, et al. Impact of Prepackaged LowResidue Diet on Bowel Preparation for Colonoscopy: A Metaanalysis. Gastroenterology Nursing. 44(2), E29–E37. doi: 10.1097/SGA.0000000000000588Zhang Y, Ding C, Li J, et al. Impact of Prepackaged Low- Residue Diet on Bowel Preparation for Colonoscopy: A Metaanalysis. Gastroenterology Nursing. 44(2), E29–E37. doi: 10.1097/SGA.0000000000000588Ahumada C, Pereyra L, Galvarini M, et al. Efficacy and tolerability of a low-residue diet for bowel preparation: systematic review and meta-analysis. Surgical Endoscopy. 2022; 3858–3875 (2022). doi: 10.1007/s00464-021-08703-8Ahumada C, Pereyra L, Galvarini M, et al. Efficacy and tolerability of a low-residue diet for bowel preparation: systematic review and meta-analysis. Surgical Endoscopy. 2022; 3858–3875 (2022). doi: 10.1007/s00464-021-08703-8Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clinical Nutrition. 2003;4(22):415–421.Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clinical Nutrition. 2003;4(22):415–421.Tajika M, Tanaka T, Ishihara M, et al. Split-dose low-volume polyethylene glycol is non-inferior but less preferred compared with same-day bowel preparation for afternoon colonoscopy. Nagoya Journal of Medical Science. 2021;4(83):787–799.Tajika M, Tanaka T, Ishihara M, et al. Split-dose low-volume polyethylene glycol is non-inferior but less preferred compared with same-day bowel preparation for afternoon colonoscopy. Nagoya Journal of Medical Science. 2021;4(83):787–799.

The authors declare that there are no conflicts of interest present.