Peng Cheng1,2, Qingqi Chen1, Juyuan Li1, Li Pang1, Caituan Feng1, Ning Wang1, Yu Bai3, Zhaoshen Li3, Xiangjun Meng2. 1. Department of Gastroenterology, Hainan West Central Hospital 2 Fubo East Road, Danzhou 571799, Hainan, China. 2. Department of Gastroenterology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine 280 Mohe Road, Shanghai 201999, China. 3. Department of Gastroenterology, Changhai Hospital, Second Military Medical University Shanghai 200000, China.
Abstract
BACKGROUND: The European Society of Gastrointestinal Endoscopy recommends 4L Polyethylene Glycol (PEG) as the standard regimen for bowel preparation (BP). The current study compared 3L and 4L PEG with regard to their effectiveness, tolerability, and safety among Chinese patients to identify the best bowel cleansing method for this population. METHODS: The study employed a prospective, observer-blinded, randomized and controlled design in a high-volume endoscopic center. Consecutive patients undergoing colonoscopy were randomly assigned (1:1) to the 3L-PEG or 4L-PEG group. The quality of bowel cleansing, procedure time, adenoma detection rate (ADR), patient tolerance, and adverse events were compared. RESULTS: A total of 330 patients were included in the study. After exclusions, 160 cases in the 3L-PEG group and 158 cases in the 4L-PEG group were included in the final analysis. The quality of bowel cleansing (Boston Bowel Preparation Scale) for both the whole intestine and each segment had no significant differences between the groups (P > 0.05). No significant differences were found with regard to procedure time or ADR. The incidences of adverse events such as nausea (P = 0.001), vomiting (P = 0.002), and bloating (P < 0.001) were lower in the 3L-PEG group. Moreover, there was a higher rate of satisfaction in the 3L-PEG group than in the 4L-PEG group (P = 0.009). CONCLUSIONS: 3L-PEG bowel cleansing represents an optimal alternative to a 4L-PEG preparation, showing similar efficacy and superior levels of satisfaction, acceptability, and safety among users. We recommend 3L PEG as a routine regimen in the clinical setting for Chinese patients. (ClinicalTrials.gov registration number: NCT03356015, registered in 29 November, 2017, https://www. CLINICALTRIALS: gov/ct2/show/NCT03356015). AJTR
BACKGROUND: The European Society of Gastrointestinal Endoscopy recommends 4L Polyethylene Glycol (PEG) as the standard regimen for bowel preparation (BP). The current study compared 3L and 4L PEG with regard to their effectiveness, tolerability, and safety among Chinese patients to identify the best bowel cleansing method for this population. METHODS: The study employed a prospective, observer-blinded, randomized and controlled design in a high-volume endoscopic center. Consecutive patients undergoing colonoscopy were randomly assigned (1:1) to the 3L-PEG or 4L-PEG group. The quality of bowel cleansing, procedure time, adenoma detection rate (ADR), patient tolerance, and adverse events were compared. RESULTS: A total of 330 patients were included in the study. After exclusions, 160 cases in the 3L-PEG group and 158 cases in the 4L-PEG group were included in the final analysis. The quality of bowel cleansing (Boston Bowel Preparation Scale) for both the whole intestine and each segment had no significant differences between the groups (P > 0.05). No significant differences were found with regard to procedure time or ADR. The incidences of adverse events such as nausea (P = 0.001), vomiting (P = 0.002), and bloating (P < 0.001) were lower in the 3L-PEG group. Moreover, there was a higher rate of satisfaction in the 3L-PEG group than in the 4L-PEG group (P = 0.009). CONCLUSIONS: 3L-PEG bowel cleansing represents an optimal alternative to a 4L-PEG preparation, showing similar efficacy and superior levels of satisfaction, acceptability, and safety among users. We recommend 3L PEG as a routine regimen in the clinical setting for Chinese patients. (ClinicalTrials.gov registration number: NCT03356015, registered in 29 November, 2017, https://www. CLINICALTRIALS: gov/ct2/show/NCT03356015). AJTR
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