Su Young Kim, Sang Hoon Lee, Jundeok Lee, Hyunil Kim, Hong Jun Park, Hyun-Soo Kim
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引用次数: 0
Abstract
Background: Patients with hematochezia often present with inadequate bowel preparation, which compromises the accuracy of colonoscopy. Despite this clinical challenge, evidence guiding optimal preparation strategies for this population is limited.
Objectives: We directly compared the efficacy and safety of ultra-low-volume (1 L) polyethylene glycol/ascorbic acid (PEG/Asc) versus low-volume (2 L) PEG/Asc in patients undergoing colonoscopy for hematochezia.
Design: In a prospective, randomized, multicenter non-inferiority trial, patients received either 1 or 2 L PEG/Asc using standard split-dose regimens.
Methods: Bowel preparation quality was assessed using the Boston Bowel Preparation Scale (BBPS). Secondary outcomes included patient satisfaction, adverse events, colonic bleeding source identification rate, and adenoma detection rate (ADR).
Results: In total, 184 patients were analyzed. Successful bowel cleansing was achieved in 78.3% of the 1 L PEG/Asc group and 76.1% of the 2 L PEG/Asc group, confirming non-inferiority. The mean BBPS score was higher with 1 L PEG/Asc (6.87 vs 6.30; p = 0.053). Patient satisfaction favored the 1 L PEG/Asc group, although the difference was not statistically significant. Colonic bleeding source identification was slightly higher in the 1 L PEG/Asc group than in the 2 L PEG/Asc group, but the difference did not reach statistical significance (82.4% vs 73.6%; p = 0.165). Completion rates, adverse events, and ADR were similar between groups.
Conclusion: Ultra-low-volume (1 L) PEG/Asc is as effective and safe as 2 L PEG/Asc for bowel preparation in patients with hematochezia. Bowel cleansing and satisfaction were higher with the 1 L PEG/Asc regimen without statistically significant differences, supporting its use as a practical alternative.
Trial registration: The study was registered with the Clinical Research Information Service, Republic of Korea, a primary registry in the WHO Registry Network (registration number: KCT0006124).
背景：便血患者通常表现为肠道准备不足，这影响了结肠镜检查的准确性。尽管存在这一临床挑战，但指导该人群最佳制剂策略的证据有限。目的：我们直接比较超低容量（1l）聚乙二醇/抗坏血酸（PEG/Asc）与低容量（2l）聚乙二醇/Asc在接受结肠镜检查的便血患者中的疗效和安全性。设计：在一项前瞻性、随机、多中心非劣效性试验中，患者使用标准分剂量方案接受1或2升PEG/Asc。方法：采用波士顿肠准备量表（Boston Bowel preparation Scale， BBPS）评价肠准备质量。次要结局包括患者满意度、不良事件、结肠出血源识别率和腺瘤检出率（ADR）。结果：共分析184例患者。1升PEG/Asc组的78.3%和2升PEG/Asc组的76.1%成功清洗肠道，证实了非劣效性。1 L PEG/Asc时，平均BBPS评分更高（6.87 vs 6.30; p = 0.053）。患者满意度倾向于1 L PEG/Asc组，尽管差异无统计学意义。1 L PEG/Asc组结肠出血源识别率略高于2 L PEG/Asc组，但差异无统计学意义（82.4% vs 73.6%; p = 0.165）。两组间的完成率、不良事件和ADR相似。结论：超低体积（1l） PEG/Asc与2l PEG/Asc用于便血患者肠道准备同样有效和安全。1升PEG/Asc方案的肠道清洁和满意度更高，无统计学显著差异，支持其作为实用替代方案的使用。试验注册：该研究在韩国临床研究信息服务中心注册，该中心是世卫组织注册网络的一个主要注册中心（注册号：KCT0006124）。
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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