Digestive Endoscopy Unit, Catholic University, Rome, Italy.
J Clin Gastroenterol. 2011 Feb;45(2):119-24. doi: 10.1097/MCG.0b013e3181dac04b.
Aim of this study is to assess the feasibility of substituting sodium phosphate (NaP) with polyethylene glycol (PEG)-boosters in the protocol preparation for PillCam Colon Capsule Endoscopy (CCE).
CCE represents a new diagnostic, endoscopic technology for colonic exploration. Bowel preparation for CCE is necessary not only to clean the colon, but also to promote capsule propulsion. For this reason, NaP boosters have been added to a 4 L PEG-preparation. NaP has been recently related with major side-effects.
Forty patients were prospectively randomized to Standard (n=20) or Modified (n=20) regimen. Standard regimen included clear liquid diet, 4 L of PEG, and 1 or 2 NaP boosters. In the Modified regimen, NaP boosters were substituted by 1 or 2 PEG boosters; 4 senna tablets and a low-residue diet were also included. Patients underwent CCE and conventional colonoscopy, carried out on the same day. CCE excretion rate, colon transit time, colon cleansing, and accuracy were evaluated.
Hundred percent and 75% of CCE were excreted with the Standard and Modified regimen, respectively (P=0.02). Mean±SE colonic transit time of capsule was 2.17±1.43 hours in the Standard group, and 5.32±2.53 hours in the Modified group (P<0.001). Adequate preparation was achieved in 42.5% of the cases, without statistically significant difference between the 2 groups (35% vs. 53%; P=NS). CCE sensitivity and specificity for ≥6 mm polyps were 63% and 87%, without difference between the 2 groups.
The exclusion of NaP booster from CCE preparation resulted into a clinically meaningful reduction of the capsule excretion rate that was only partially compensated by the PEG booster.
本研究旨在评估在 PillCam 结肠胶囊内镜（CCE）方案准备中用聚乙二醇（PEG）增强剂替代磷酸钠（NaP）的可行性。
CCE 代表了一种新的诊断性内镜结肠检查技术。CCE 肠道准备不仅需要清洁结肠，还需要促进胶囊推进。因此，在 4 L PEG 准备液中加入了 NaP 增强剂。最近，NaP 与主要副作用有关。
40 例患者前瞻性随机分为标准（n=20）或改良（n=20）组。标准方案包括清淡饮食、4 L PEG 和 1 或 2 个 NaP 增强剂。在改良方案中，用 1 或 2 个 PEG 增强剂替代 NaP 增强剂；还包括 4 片番泻叶和低残留饮食。患者同日进行 CCE 和常规结肠镜检查。评估 CCE 排泄率、结肠传输时间、结肠清洁度和准确性。
标准组和改良组分别有 100%和 75%的 CCE 排出（P=0.02）。标准组胶囊平均结肠传输时间为 2.17±1.43 小时，改良组为 5.32±2.53 小时（P<0.001）。42.5%的病例达到了充分的准备，两组之间无统计学差异（35%比 53%；P=NS）。CCE 对≥6mm 息肉的敏感性和特异性分别为 63%和 87%，两组之间无差异。
在 CCE 准备中排除 NaP 增强剂导致胶囊排泄率显著降低，但仅部分由 PEG 增强剂补偿。
