Efficacy of ultra-low volume (≤1 L) bowel preparation fluids: Systematic review and meta-analysis
| Autor: | Peter D. Siersema, Milou L M van Riswijk, Kelly E. van Keulen |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adenoma
medicine.medical_specialty Sodium picosulfate Colonoscopy Cathartic Ascorbic Acid Gastroenterology law.invention Polyethylene Glycols Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Randomized controlled trial law Internal medicine Clinical endpoint Medicine Humans Radiology Nuclear Medicine and imaging medicine.diagnostic_test business.industry Cathartics medicine.disease chemistry 030220 oncology & carcinogenesis Meta-analysis Bowel preparation 030211 gastroenterology & hepatology business |
| Zdroj: | Digestive Endoscopy, 34, 1, pp. 13-32 Digestive Endoscopy, 34, 13-32 |
| ISSN: | 1443-1661 0915-5635 |
| Popis: | Contains fulltext : 252154.pdf (Publisher’s version ) (Open Access) BACKGROUND AND AIMS: High-quality bowel preparation is paramount for the diagnostic accuracy and safety of colonoscopy; however, it is often difficult for patients to adhere to high-volume laxatives, which may contribute to poor bowel preparation. This review aims to assess the efficacy of bowel preparation fluids of 1 L or less (≤1 L). METHODS: We performed a systematic review including all relevant randomized controlled trials on ultra-low volume (≤1 L) bowel preparation fluids for colonoscopy published since 2015. Primary endpoint was the percentage of adequately prepared patients. Secondary endpoints included adenoma detection rate (ADR) and safety. RESULTS: Bowel preparation with sodium picosulfate/magnesium citrate (SPMC; 19 trials, n = 10,287), 1L-polyethylene glycol with ascorbate (PEGA; 10 trials, n = 1717), sodium phosphate (NaP; 2 trials, n = 621), and oral sulfate solution (OSS; 3 trials, n = 597) was adequate in 75.2%, 82.9%, 81.9%, and 92.1%, respectively, of patients; however, heterogeneity between studies was considerable (I(2) range: 86-98%). Pooled ADRs were 31.1% with SPMC, 32.3% with 1L-PEGA, 30.4% with NaP, and 40.9% with OSS. Temporary electrolyte changes were seen with all ultra-low volume bowel preparation fluid solutions but without sustained effects in most patients. CONCLUSION: Ultra-low volume bowel preparation fluids do not always meet the 90% quality standard for adequate bowel preparation as defined by current guidelines. Nonetheless, they may be considered in patients intolerant for higher-volume laxatives and without risk factors for inadequate bowel preparation or dehydration-related complications. |
| Databáze: | OpenAIRE |
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