A COMPARISON OF THE EFFECTIVENESS OF THE SODIUM PHOSPHATE AND SENNOSIDES USED IN PREPARATION FOR COLONOSCOPY. Kolonoskopi haz?rl??? i?in kullan?lan NaP ve Sennosid bile?iklerinin etkinliklerinin kar??la?t?r?lmas?.

摘要

Polyethylene glycol (PEG) and sodium phosphate (NaP) are routinely used for colonoscopy preparation (CP). However, PEG’s high volume and the fact that NaP can cause electrolyte anomalies and renal toxicity limit the use of these in high risk patient groups. Sennosides, which are not commonly used exclusively for CP, are better tolerated but are thought to provide inadequate cleansing and are therefore generally employed additionally to a PEG regimen. The exclusive use of sennosides for CP is controversial. This study compared the effects of NaP and sennosides in CP. Patients undergoing colonoscopy and admitted to the colonoscopy unit from June 2013 to August 2014 were investigated retrospectively. Patients using NaP and sennoside in the cleansing protocol were compared on the basis of the cleansing regimen used in terms of age, sex, body mass index (BMI), potential complications during preparation such as nausea, vomiting, abdominal pain, headache and dizziness, time to reach the cecum, total duration of colonoscopy, rate of polyp determination and colonic cleanliness based on the Boston Bowel Preparation Scale (BPPS). Forty (46.0%) of the 87 patients were male and 47 (54.0%) were female. Mean age was 53.7±12.0 and mean BMI was 28.5±4.4. No significant difference was determined between the groups in terms of sex, age or BMI. Right colon BPPS score was significantly higher in the NaP group than in the sennoside group (2.4±0.6 and 2.1±0.8, respectively). This elevation did not significantly affect the rates of polyp detection between the groups. Significantly more nausea, vomiting, dizziness and headache were seen in the NaP group. NaP has a higher incidence of side-effects but provides more effective cleansing in the cecum and descending colon compared to sennosides, although this does not significantly affect the rate of polyp detection. We therefore suggest that the better-tolerated sennosides can be used as an alternative to NaP in routine preparation for colonoscopy. ?zet Kolonoskopi haz?rl???nda polietilen glikol (PEG) ve sodyum fosfat (NaP) rutin olarak kullan?lmaktad?r. Fakat PEG’in yüksek volüm i?eri?i, NaP’?n ise elektrolit anomalileri ve renal toksisiteye neden olabilmesi riskli hasta gruplar?nda kullan?mlar?n? k?s?tlamaktad?r. Kolon temizli?i i?in tek ba??na kullan?lmas? daha az tercih edilen Sennosidler ise daha iyi tolere edilmektedir fakat yetersiz temizlik sa?lad??? dü?üncesiyle daha ?ok PEG rejimine ek olarak kullan?lmaktad?rlar. Sennosidlerin kolon temizli?i i?in tek ba??na kullan?lmas? ise tart??mal?d?r. Bu ?al??mada kolonoskopi haz?rl???nda NaP ve Sennosidlerin etkileri kar??la?t?r?ld?. Haziran 2013 ve a?ustos 2014 tarihleri aras?nda kolonoskopi yap?lan ve temizlik protokolünde NaP ile sennosid bazl? ila?lar kullan?lan hastalar retrospektif olarak incelendi. Hastalar kullan?lan temizlik rejimine g?re ya?, cinsiyet, body mass index (BMI) ve haz?rl?k s?ras?nda olabilecek bulant?, kusma, kar?n a?r?s?, ba? a?r?s?, ba? d?nmesi gibi komplikasyonlar, ?ekuma ula?ma süresi, total kolonoskopi süresi, polip saptanma oran? ve Boston Bowel Preperation Scale (BPPS)’ya g?re kolon temizli?i a??s?ndan kar??la?t?r?ld?. ?al??maya al?nan 87 hastan?n 40 (46.0%)’? erkek, 47 (54.0%)’si kad?nd?. Ortalama ya? 53,7±12,0, BMI 28,5±4,4 idi. Gruplar aras?nda cinsiyet, ya? ve BMI a??s?ndan anlaml? fark saptanmad?. Sa? kolon BBPS skoru NaP kullanan grupta Sennosid grubuna g?re anlaml? olarak daha yüksekti (s?ras?yla 2,4±0,6 ve 2,1±0,8). Bu yükseklik gruplar aras?nda polip saptanma oran?n? anlaml? olarak de?i?tirmemi?ti. Bulant?, kusma, ba?d?nmesi ve ba?a?r?s? NaP kullan?lan grupta anlaml? olarak daha fazla g?rülmü?tü. Daha yüksek yan etki insidans?na sahip olan NaP ?ekum ve ??kan kolonda sennosidlerden daha etkin temizlik sa?l?yor fakat bu durum polip saptanma oran?n? anlaml? olarak de?i?tirmiyor. Bu yüzden biz daha iyi tolere edilebilen sennosidlerin NaP a alternatif olarak kolonoskopi haz?rl???nda rutin olarak kullan?labilece?ini dü?ünüyoruz.