Same-day single-dose vs large-volume split-dose regimens of polyethylene glycol for bowel preparation:A systematic review and meta-analysis  

作　　者：Hui Pan Xiao-Ling Zheng Chao-Ying Fang Lan-Zai Liu Jian-Su Chen Chao Wang Yu-Dai Chen Jian-Min Huang Yu-Shen Zhou Li-Ping He 

机构地区：[1]Gastrointestinal Endoscopy Center,Fujian Provincial Hospital,The Shengli Clinical Medical College,Fujian Medical University,Fuzhou 350001,Fujian Province,China [2]Gastrointestinal Endoscopy Center,Fujian Provincial Hospital South Branch,Fuzhou 350001,Fujian Province,China

出　　处：《World Journal of Clinical Cases》2022年第22期7844-7858,共15页世界临床病例杂志

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(P<0.05).No significant difference in adverse effects,including nausea,vomiting and bloating,was found between the two arms(P>0.05).CONCLUSION Regardless of adjuvant laxative use,the(2 L/4 L)SSD PEG-based

关 键 词：Bowel preparation Colonoscopy Polyethylene glycol Same-day single-dose Split-dose Metaanalysis 

分 类 号：R969[医药卫生—药理学]