AIM: To compare same-day whole-dose vs split-dose of 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for colon cleansing for morning colonoscopy.
BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep dis...BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep disturbance associated with night doses.Meanwhile,the same-day single-dose regimens(SSDs)of PEG has been recommended as an alternative;however,its superiority compared to other regimens is a matter of debate.AIM To compare the efficacy and tolerability between SSDs and large-volume SpDs PEG for bowel preparation.METHODS We searched MEDLINE/PubMed,the Cochrane Library,RCA,EMBASE and Science Citation Index Expanded for randomized trials comparing(2 L/4 L)SSDs to large-volume(4 L/3 L)SpDs PEG-based regimens,regardless of adjuvant laxative use.The pooled analysis of relative risk ratio and mean difference was calculated for bowel cleanliness,sleep disturbance,willingness to repeat the procedure using the same preparation and adverse effects.A random effects model or fixed-effects model was chosen based on heterogeneity analysis among studies.RESULTS A total of 18 studies were included.There was no statistically significant difference of adequate bowel preparation(relative risk=0.97;95%CI:0.92-1.02)(14 trials),right colon Boston Bowel Preparation Scale(mean difference=0.00;95%CI:-0.04,0.03)(9 trials)and right colon Ottawa Bowel Preparation Scale(mean difference=0.04;95%CI:-0.27,0.34)(5 trials)between(2 L/4 L)SSDs and large-volume(4 L/3 L)SpDs,regardless of adjuvant laxative use.The pooled analysis favored the use of SSDs with less sleep disturbance(relative risk=0.52;95%CI:0.40,0.68)and lower incidence of abdominal pain(relative risk=0.75;95%CI:0.62,0.90).During subgroup analysis,patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation than SpDs(P0.05).CONCLUSION Regardless of adjuvant laxative use,the(2 L/4 L)SSD PEG-based arm was considered equal or better than the large-volume(≥3 L)SpDs PEG regimen in terms of bowel cleanliness and tolerability.Patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation due to the low-volume fluid requirement and less sleep disturbance.展开更多
To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODS...To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODSFrom February 2015 to March 2015, examinees of average risk who were scheduled for a colonoscopy in the morning were retrospectively enrolled.RESULTSThe 189 examinees were divided into split-dose and non-split-dose groups. The adequacy of bowel preparation for the split-dose group vs the non-split-dose group was 96.8% vs 85.2%, respectively, P < 0.001, and the compliance of the last meal restriction was 74.6% vs 58.2%, respectively, P < 0.001. The sleep disturbance (P < 0.001) was more prevalent in the split-dose group, however the willingness to repeat the same preparation method (P = 0.243) was not different in both groups. The split-dose regimen was the most important factor influencing adequate bowel preparation in multivariate analysis (HR = 10.89, 95%CI: 6.53-18.17, P < 0.001).CONCLUSIONA split-dose regimen of 2 L PEG/AA for an early morning colonoscopy was more effective and showed better compliance for diet restriction without any difference in satisfaction and discomfort. Introducing a split-dose regimen of 2 L PEG/AA to morning colonoscopy examinees is effective and tolerable in a comprehensive medical check-up setting.展开更多
BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results ...BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results have varied.AIM To examine the outcomes of SaD and SpD for afternoon colonoscopies.METHODS An extensive literature search was conducted using multiple databases.Only randomized controlled trials(RCTs)in adults that compared SaD to SpD with Ottawa bowel preparation score(OBPS)were included.Odds ratio(OR)or mean difference was used to analyze outcomes.RESULTS Eleven RCTs were included(n=1846).No difference was observed for satisfactory bowel preparation based on OBPS among participants receiving SaD vs SpD(OR 0.77;95%CI:-0.57-1.03;P=0.07;I2=5%).Subgroup analysis showed no difference in terms of satisfactory bowel preparation based on OBPS between the two groups when receiving same preparation formula(polyethylene glycol)(OR 0.83;95%CI:0.51-1.35;P=0.46;I2=39%)as well as receiving same formula and volume(4 L polyethylene glycol)(OR 1.14;95%CI:0.65-2.01;P=0.64;I2=0%).CONCLUSION In patients undergoing afternoon colonoscopies,SaD is comparable with SpD in terms of satisfactory bowel preparation.Further studies are needed to validate these results and determine the optimal formula and dosages.展开更多
目的探究20 g硫酸镁联合低剂量聚乙二醇电解质散(PEG)在结肠镜检查前的肠道清洁效果。方法选取2023年2-6月临沂市人民医院行结肠镜检查患者400例,采用随机数字法将患者分成A、B、C、D四组。A组:2 L PEG+30mL西甲硅油;B组:50 g硫酸镁+30...目的探究20 g硫酸镁联合低剂量聚乙二醇电解质散(PEG)在结肠镜检查前的肠道清洁效果。方法选取2023年2-6月临沂市人民医院行结肠镜检查患者400例,采用随机数字法将患者分成A、B、C、D四组。A组:2 L PEG+30mL西甲硅油;B组:50 g硫酸镁+30 mL西甲硅油;C组:标准大剂量4 L PEG+30 mL西甲硅油;D组:20 g硫酸镁+2 L PEG+30 mL西甲硅油。观察记录患者波士顿肠道准备量表(BBPS)评估的肠道清洁质量。次要结果是评估息肉检出率及不良反应发生率。结果D组肠道准备充分率与C组相当(95.7%vs 97.7%),B组肠道准备充分率最低(78.8%)。全结肠及各肠段BBPS评分数据分析显示,D组和C组均有较好的肠道清洁效果,A组最差。四组息肉检出率差异无统计学意义(P>0.05)。四组不良反应发生率差异无统计学意义(P>0.05),D组未明显增加不良反应发生率。结论20 g硫酸镁联合低剂量(2 L)聚乙二醇电解质散具有较好的肠道准备效果,且具有一定的安全性,可作为未来肠道准备的推荐方案。展开更多
基金Supported by University of Malaya Research Grant,Project No.RG536-13HTM
摘要AIM: To compare same-day whole-dose vs split-dose of 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for colon cleansing for morning colonoscopy.
基金Supported by Startup Fund for scientific research,Fujian Medical University,No. 2019QH1181
摘要BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep disturbance associated with night doses.Meanwhile,the same-day single-dose regimens(SSDs)of PEG has been recommended as an alternative;however,its superiority compared to other regimens is a matter of debate.AIM To compare the efficacy and tolerability between SSDs and large-volume SpDs PEG for bowel preparation.METHODS We searched MEDLINE/PubMed,the Cochrane Library,RCA,EMBASE and Science Citation Index Expanded for randomized trials comparing(2 L/4 L)SSDs to large-volume(4 L/3 L)SpDs PEG-based regimens,regardless of adjuvant laxative use.The pooled analysis of relative risk ratio and mean difference was calculated for bowel cleanliness,sleep disturbance,willingness to repeat the procedure using the same preparation and adverse effects.A random effects model or fixed-effects model was chosen based on heterogeneity analysis among studies.RESULTS A total of 18 studies were included.There was no statistically significant difference of adequate bowel preparation(relative risk=0.97;95%CI:0.92-1.02)(14 trials),right colon Boston Bowel Preparation Scale(mean difference=0.00;95%CI:-0.04,0.03)(9 trials)and right colon Ottawa Bowel Preparation Scale(mean difference=0.04;95%CI:-0.27,0.34)(5 trials)between(2 L/4 L)SSDs and large-volume(4 L/3 L)SpDs,regardless of adjuvant laxative use.The pooled analysis favored the use of SSDs with less sleep disturbance(relative risk=0.52;95%CI:0.40,0.68)and lower incidence of abdominal pain(relative risk=0.75;95%CI:0.62,0.90).During subgroup analysis,patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation than SpDs(P0.05).CONCLUSION Regardless of adjuvant laxative use,the(2 L/4 L)SSD PEG-based arm was considered equal or better than the large-volume(≥3 L)SpDs PEG regimen in terms of bowel cleanliness and tolerability.Patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation due to the low-volume fluid requirement and less sleep disturbance.
摘要To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODSFrom February 2015 to March 2015, examinees of average risk who were scheduled for a colonoscopy in the morning were retrospectively enrolled.RESULTSThe 189 examinees were divided into split-dose and non-split-dose groups. The adequacy of bowel preparation for the split-dose group vs the non-split-dose group was 96.8% vs 85.2%, respectively, P < 0.001, and the compliance of the last meal restriction was 74.6% vs 58.2%, respectively, P < 0.001. The sleep disturbance (P < 0.001) was more prevalent in the split-dose group, however the willingness to repeat the same preparation method (P = 0.243) was not different in both groups. The split-dose regimen was the most important factor influencing adequate bowel preparation in multivariate analysis (HR = 10.89, 95%CI: 6.53-18.17, P < 0.001).CONCLUSIONA split-dose regimen of 2 L PEG/AA for an early morning colonoscopy was more effective and showed better compliance for diet restriction without any difference in satisfaction and discomfort. Introducing a split-dose regimen of 2 L PEG/AA to morning colonoscopy examinees is effective and tolerable in a comprehensive medical check-up setting.
摘要BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results have varied.AIM To examine the outcomes of SaD and SpD for afternoon colonoscopies.METHODS An extensive literature search was conducted using multiple databases.Only randomized controlled trials(RCTs)in adults that compared SaD to SpD with Ottawa bowel preparation score(OBPS)were included.Odds ratio(OR)or mean difference was used to analyze outcomes.RESULTS Eleven RCTs were included(n=1846).No difference was observed for satisfactory bowel preparation based on OBPS among participants receiving SaD vs SpD(OR 0.77;95%CI:-0.57-1.03;P=0.07;I2=5%).Subgroup analysis showed no difference in terms of satisfactory bowel preparation based on OBPS between the two groups when receiving same preparation formula(polyethylene glycol)(OR 0.83;95%CI:0.51-1.35;P=0.46;I2=39%)as well as receiving same formula and volume(4 L polyethylene glycol)(OR 1.14;95%CI:0.65-2.01;P=0.64;I2=0%).CONCLUSION In patients undergoing afternoon colonoscopies,SaD is comparable with SpD in terms of satisfactory bowel preparation.Further studies are needed to validate these results and determine the optimal formula and dosages.