Oral sulfate solution versus polyethylene glycol for bowel preparation before colonoscopy, meta-analysis and trial sequential analysis of randomized clinical trials.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2024-08-13 DOI:10.1007/s10151-024-02981-9

X Liu, W Yu, J Liu, Q Liu

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引用次数: 0

Abstract

Background: This study aimed to compare oral sulfate solution (OSS) with polyethylene glycol (PEG) for bowel preparation before colonoscopy.

Methods: A literature search was performed on PubMed, Ovid, and Cochrane Databases for randomized clinical trials (RCT) comparing OSS with PEG for bowel preparation before colonoscopy. The last search was performed on 22 August 2023. The primary outcome was the quality of bowel preparation. The outcomes were compared by meta-analysis and trial sequential analysis (TSA).

Results: A total of 14 RCTs with 4526 patients were included. OSS was comparable with PEG regarding adequate bowel preparation [P = 0.16, odds ratio (OR) = 1.19, 95% confidence interval (CI) [0.93, 1.51], I² = 0%]. However, OSS showed obvious priority in excellent bowel preparation (P < 0.001, OR = 1.62, 95% CI [1.27, 2.05], I² = 0%) and total Boston bowel preparation scale (BBPS) [P = 0.02, weighted mean difference (WMD) = 0.27, 95% CI [0.05, 0.50], I² = 84%]. Additionally, the detection rate of polyps (P = 0.001, OR = 1.44, 95% CI [1.15, 1.80], I² = 0%) and adenoma (P = 0.007, OR = 1.22, 95% CI [1.06, 1.42], I² = 0%) was significantly higher in the OSS group. The two groups showed comparable incidence of adverse events except for a higher incidence of dizziness (P = 0.02, OR = 1.74, 95% CI [1.08, 2.83], I² = 11%) was indicated in the OSS group. Moreover, OSS was associated with a higher satisfaction score (P = 0.02, WMD = 0.62, 95% CI [0.09, 1.15], I² = 70%). In the TSA, the cumulative Z-curve crossed both the conventional boundary and trial sequential monitoring boundary and the required information size has been reached for excellent bowel preparation and total BBPS.

Conclusion: The current data demonstrated that OSS was associated with better quality of bowel preparation. More clinical trials are still needed to confirm other outcomes.

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在结肠镜检查前进行肠道准备时，硫酸口服溶液与聚乙二醇的比较，随机临床试验的荟萃分析和试验顺序分析。

背景：本研究旨在比较硫酸口服液（OSS）和聚乙二醇（PEG）在结肠镜检查前的肠道准备：本研究旨在比较硫酸口服溶液（OSS）和聚乙二醇（PEG）在结肠镜检查前的肠道准备：方法：在 PubMed、Ovid 和 Cochrane 数据库中进行文献检索，比较 OSS 与 PEG 用于结肠镜检查前肠道准备的随机临床试验 (RCT)。最后一次检索于 2023 年 8 月 22 日进行。主要结果是肠道准备的质量。通过荟萃分析和试验序列分析（TSA）对结果进行比较：结果：共纳入了 14 项 RCT，4526 名患者。在充分的肠道准备方面，OSS 与 PEG 具有可比性[P = 0.16，几率比（OR）= 1.19，95% 置信区间（CI）[0.93, 1.51]，I2 = 0%]。然而，OSS 在肠道准备优良率（P 2 = 0%）和波士顿肠道准备总评分（BBPS）方面表现出明显的优先性[P = 0.02，加权平均差（WMD）= 0.27，95% 置信区间（CI）[0.05，0.50]，I2 = 84%]。此外，OSS 组的息肉（P = 0.001，OR = 1.44，95% CI [1.15，1.80]，I2 = 0%）和腺瘤（P = 0.007，OR = 1.22，95% CI [1.06，1.42]，I2 = 0%）检出率明显更高。两组的不良反应发生率相当，但 OSS 组的头晕发生率较高（P = 0.02，OR = 1.74，95% CI [1.08，2.83]，I2 = 11%）。此外，OSS 与较高的满意度得分相关（P = 0.02，WMD = 0.62，95% CI [0.09，1.15]，I2 = 70%）。在 TSA 中，累积 Z 曲线越过了常规边界和试验序列监测边界，达到了优秀肠道准备和总 BBPS 所需的信息量：目前的数据表明，OSS 与更高质量的肠道准备相关。仍需更多临床试验来证实其他结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.