Retrospective Study
Copyright ©The Author(s) 2025.
World J Gastrointest Surg. Jun 27, 2025; 17(6): 106264
Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.106264
Table 1 Baseline characteristics of the study participants
Characteristic
Conventional bowel preparation group (n = 65)
Enhanced bowel preparation group (n = 65)
P value
Age (years)55.2 ± 10.354.8 ± 10.50.82
Gender, n (%)
    Male38 (58.5)37 (56.9)0.85
    Female27 (41.5)28 (43.1)
BMI (kg/m2)24.1 ± 3.223.9 ± 3.10.78
Comorbidities, n (%)
    Hypertension15 (23.1)14 (21.5)0.89
    Diabetes8 (12.3)7 (10.8)0.81
    Cardiovascular disease5 (7.7)4 (6.2)0.76
Polyp characteristics
    Number of polyps1.3 ± 0.61.4 ± 0.50.42
    Mean polyp size (mm)8.2 ± 2.18.0 ± 2.00.68
Polyp type, n (%)
    Adenomatous40 (61.5)42 (64.6)0.72
    Hyperplastic20 (30.8)19 (29.2)
    Serrated5 (7.7)4 (6.2)
Previous colonoscopy, n (%)10 (15.4)11 (16.9)0.85
Family history of colorectal cancer, n (%)8 (12.3)7 (10.8)0.81
Current use of anticoagulants, n (%)5 (7.7)4 (6.2)0.76
History of inflammatory bowel disease, n (%)2 (3.1)1 (1.5)0.50
Table 2 Bowel preparation quality
Indicator
Conventional bowel preparation group (n = 65)
Enhanced bowel preparation group (n = 65)
P value
Boston bowel preparation scale score
Total score3.1 ± 0.84.2 ± 0.7< 0.001
Rectum-sigmoid1.2 ± 0.41.6 ± 0.3< 0.001
Transverse-descending1.0 ± 0.31.4 ± 0.4< 0.001
Ascending-cecum0.9 ± 0.31.2 ± 0.3< 0.001
Adequacy of the bowel preparation rate85.0% (55/65)92.3% (60/65)0.04
Cecal intubation rate90.8% (59/65)95.4% (62/65)0.21
Withdrawal time (min)6.2 ± 1.28.1 ± 1.4< 0.001
Adenoma detection rate 30.8% (20/65)38.5% (25/65)0.23
Sessile serrated lesion detection rate5.0% (3/65)7.7% (5/65)0.42
Frequency of recommending an appropriate screening or surveillance interval86.2% (56/65)93.8% (61/65)0.12
Table 3 Procedure-related parameters
Parameter
Conventional bowel preparation group (n = 65)
Enhanced bowel preparation group (n = 65)
P value
Operative time (min)25.4 ± 5.223.1 ± 4.80.03
One-time complete resection rate83.1% (54/65)95.4% (62/65)0.01
Intraoperative blood loss (mL)20.3 ± 5.118.2 ± 4.50.04
Number of polyps detected1.3 ± 0.61.4 ± 0.50.42
Mean polyp size (mm)8.2 ± 2.18.0 ± 2.00.68
Adenoma detection rate 30.8% (20/65)38.5% (25/65)0.23
Sessile serrated lesion detection rate5.0% (3/65)7.7% (5/65)0.42
Frequency of recommending an appropriate screening or surveillance interval86.2% (56/65)93.8% (61/65)0.12
Postoperative hospital stay (days)3.4 ± 0.82.1 ± 0.5< 0.001
Time to first liquid diet (hours)12.3 ± 2.110.2 ± 1.80.02
Postoperative pain score3.8 ± 0.92.3 ± 0.7< 0.001
Frequency of use of additional sedation during the procedure20.0% (13/65)10.8% (7/65)0.12
Frequency of need for repeat colonoscopy due to inadequate preparation10.8% (7/65)3.1% (2/65)0.05
Frequency of patient satisfaction with procedure76.9% (50/65)87.7% (57/65)0.04
Table 4 Enhanced bowel preparation reduces complications and improves patient experience, n (%)
Complication
Conventional bowel preparation group (n = 65)
Enhanced bowel preparation group (n = 65)
P value
Total complication rate16.9% (11/65)5.9% (4/65)0.05
Bleeding11 (16.9)1 (1.5)0.01
Perforation2 (3.1)0 (0.0)0.10
Infection5 (7.7)1 (1.5)0.04
Nausea and vomiting8 (12.3)3 (4.6)0.12
Abdominal pain10 (15.4)4 (6.2)0.04
Abdominal distension7 (10.8)2 (3.1)0.07
Need for additional sedation5 (7.7)2 (3.1)0.21
Patient dissatisfaction with the preparation9 (13.8)3 (4.6)0.05
Table 5 Postoperative recovery
Indicator
Conventional bowel preparation group (n = 65)
Enhanced bowel preparation group (n = 65)
P value
Postoperative hospital stay (days)3.4 ± 0.82.1 ± 0.5< 0.001
Time to first liquid diet (h)12.3 ± 2.110.2 ± 1.80.02
Postoperative pain score3.8 ± 0.92.3 ± 0.7< 0.001
Time to the first bowel movement (h)24.5 ± 4.218.3 ± 3.1< 0.001
Postoperative fatigue score4.2 ± 0.82.8 ± 0.6< 0.001
Patient satisfaction with recovery70.8% (46/65)89.2% (58/65)0.01
Postoperative nausea and vomiting15.4% (10/65)4.6% (3/65)0.04
Postoperative dizziness10.8% (7/65)3.1% (2/65)0.07
Postoperative urinary retention7.7% (5/65)1.5% (1/65)0.05
Table 6 Pathological examination and follow-up, n (%)
Indicator
Conventional bowel preparation group (n = 65)
Enhanced bowel preparation group (n = 65)
P value
Pathological confirmation of malignancy5 (7.7)4 (6.2)0.76
6-month recurrence rate10.8% (7/65)3.1% (2/65)0.05
Late complications2 (3.1)0 (0.0)0.10
Tumor marker levels (CA19-9)35.2 ± 10.328.1 ± 8.50.02
Tumor marker levels (CEA)4.8 ± 1.23.9 ± 0.90.04
Lymph node metastasis rate12.3% (8/65)7.7% (5/65)0.32
Postoperative infection rate7.7% (5/65)3.1% (2/65)0.10
Patient satisfaction with the pathological results80.0% (52/65)87.7% (57/65)0.12
Table 7 Patient compliance and adverse reactions
Indicator
Conventional bowel preparation group (n = 65)
Enhanced bowel preparation group (n = 65)
P value
Overall compliance rate70.8% (46/65)89.2% (58/65)0.01
Adherence to the medication schedule68.0% (44/65)84.6% (55/65)0.02
Completion of the full bowel preparation course65.0% (42/65)86.2% (56/65)0.003
Frequency of adverse drug reactions12.3% (8/65)4.6% (3/65)0.04
Patient satisfaction with medication72.3% (47/65)87.7% (57/65)0.02
Frequency of additional sedation required7.7% (5/65)3.1% (2/65)0.21
Patient dissatisfaction with the preparation process13.8% (9/65)4.6% (3/65)0.05
Frequency of nausea and vomiting15.4% (10/65)4.6% (3/65)0.04
Frequency of abdominal distension10.8% (7/65)3.1% (2/65)0.07