Different position from traditional left lateral for colonoscopy? A meta-analysis and systematic review of randomized control trials.

Autor: Lin SY; Division of Colorectal Surgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Yaow CYL; Division of Colorectal Surgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Ng CH; Division of Colorectal Surgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Wong NW; Division of Colorectal Surgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Tham HY; Division of Colorectal Surgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Chong CS; Division of Colorectal Surgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore.
Jazyk: angličtina
Zdroj: Chronic diseases and translational medicine [Chronic Dis Transl Med] 2020 Oct 22; Vol. 7 (1), pp. 27-34. Date of Electronic Publication: 2020 Oct 22 (Print Publication: 2021).
DOI: 10.1016/j.cdtm.2020.09.002
Abstrakt: Background: Colonoscopy requires the intubation of the cecum for screening of colorectal diseases. The conventional position used for colonoscopy is the left lateral position (LLP). However, alternative positions have also been utilized to enhance the success of intubation. Thus, the aim of this study was to perform a meta-analysis of the different positions to determine the effectiveness of the individual positions for successful colonoscopy.
Methods: Medline, Embase and Cochrane trials electronic databases were searched for studies on colonoscopy positions. The primary outcome was defined as the cecal intubation rate. Pooled risk ratios (RR) and 95% confidence intervals (CI) for the rates of cecal intubation were estimated. Secondary outcomes such as the cecal intubation time and adenoma detection rate were further analyzed qualitatively.
Results: After reviewing 644 identified records, 7 randomized control trials (RCT) studies were included. No significant difference was observed in either comparisons, between the LLP vs. supine position (SP) (RR = 1.01, 95% CI, 0.98 to 1.04, P  = 0.55) or the LLP vs. prone position (PP) (RR = 1.02, 95% CI, 0.98 to 1.06, P  = 0.27).
Conclusions: Amidst available literature, the use of other positions can be considered when performing colonoscopy. These further highlights that the existential practice is based predominantly on familiarity instead of evidence-based-research.
Competing Interests: None.
(© 2020 Chinese Medical Association. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd.)
Databáze: MEDLINE
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