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DOI: 10.1055/s-0035-1545042
Vergleich der koloskopischen Untersuchungszeit zwischen Querschnittspatienten und gesunden Patienten
Fragestellung:
The aim of our study was to compare the procedure time of colonoscopy in patients with spinal cord injury and healthy patients.
Methodik:
In each arm of the two groups we analysed 116 patients. We did not work with X-ray control or navigation systems.
The patients with spinal cord injuries underwent a special bowel preparation regimen over 3 days.
The healthy patients in the other group underwent the usual preparation regimen beginning with the drinking of the preparation fluid at the previous day. After drinking a plain stock the patients begin to drink 3 l of the preparation fluid delcoprep at approximately 2 pm. On the examination day the patients drink another 1 liter in the early morning before appearing to the examination.
The preparation was estimated according to the Boston Bowel Preparation Score:
|
0 |
no preparation, solid stool |
|
1 |
restricted assessment, partly solid stool, partly murky secretion |
|
2 |
little impurity, good view |
|
3 |
complete mucosal visibility, only a few crumbs |
Ergebnisse:
The analysed patients were 65.3 years in mean in the healthy patients and 61,5 years in mean in the group with spinal cord injuries.
The rate of reaching the cecal pole in both groups was complete.
The poly detection rate was 56 percent in the healthy patients and 47 percent in the group of patients with spinal cord injuries.
Because of the fact of an inferior bowel preparation condition in patients with spinal cord injury we had had a longer colonoscopy procedure time in order to get satisfactory results. This could be achieved by a nearly doubled time of pushing forward and longer drawing back time because of extensive irrigation need.
We made the experience that the patients with spinal cord injuries had a more unstressed and relaxed large bowel intestine complicated by a lash abdominal wall related to regressed abdominal muscles.
The results of our investigation are shown in table 2.
|
Cleanness according BBPS |
2,68 |
2,03 |
|
Pushing forward time in minutes (absolute and in average) |
1114 (9,6) |
2148 (18,51) |
|
Drawing back time (absolute and in average) |
1994 (17,19) |
2348 (20,24) |
|
Number of patients with interventional procedures |
55 |
55 |
Even the procedure of placing a peripheral venous catheter took much more time compared to a healthy patient.
Schlussfolgerung:
We want to point to the longer large bowel preparation time and to the longer colonoscopy procedure time in patients with spinal cord injuries in comparison to healthy patients.
In summary we want to indicate that the planning and performing of colonoscopy in patients with spinal cord injuries is much more difficult and has to be considered in the estimation in the diagnosis related groups.