Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, SoonChunHyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon and Seoul, 420-767, Korea.
Dig Dis Sci. 2019 Sep;64(9):2607-2613. doi: 10.1007/s10620-019-05599-2. Epub 2019 Apr 11.
Colonic bubbles obscure the colonic mucosa during colonoscopy following bowel preparation with polyethylene glycol plus ascorbic acid (PEG-Asc). Simethicone is used to enhance visualization during colonoscopy. We aimed to determine the optimal timing of simethicone addition to improve bowel preparation using PEG-Asc.
This prospective, randomized study enrolled patients undergoing elective colonoscopy from April 2017 to January 2018. They were randomly assigned to one of the following three groups: PEG-Asc only (control) or simethicone addition in the morning on the day of colonoscopy (PEG-S1) or in the evening of the day prior to colonoscopy (PEG-S2). The primary outcome was the quality of colon cleansing, and the secondary outcomes were the adenoma detection rate (ADR), polyp detection rate (PDR), and diminutive (≤ 5 mm) ADR.
In total, 240 patients were randomly allocated to the three groups; six patients were withdrawn. Of the 234 patients evaluated, 78, 79, and 77 were allocated to the control, PEG-S1, and PEG-S2 groups, respectively. The bubble scores of all colonic segments were lowest in the PEG-S2 group. There was no significant difference in ADR or PDR among the three groups. However, the diminutive ADR was significantly higher in the PEG-S2 group compared to the other two groups (control 5.1% vs. PEG-S1 8.9% vs. PEG-S2 20.8%; P = 0.009).
Addition of simethicone to PEG-Asc at the optimal time prevents the formation of air bubbles and so improves the quality of bowel preparation, especially enhancing diminutive ADR.
在聚乙二醇加维生素 C（PEG-Asc）肠道准备后行结肠镜检查时，结肠气泡会使结肠黏膜模糊。二甲硅油用于增强结肠镜检查时的可视化效果。我们旨在确定添加二甲硅油以改善 PEG-Asc 肠道准备的最佳时机。
这是一项前瞻性、随机研究，纳入了 2017 年 4 月至 2018 年 1 月期间接受择期结肠镜检查的患者。他们被随机分为以下三组：仅 PEG-Asc（对照组）或在结肠镜检查当天上午（PEG-S1）或前一天晚上（PEG-S2）添加二甲硅油。主要结局是结肠清洁质量，次要结局是腺瘤检出率（ADR）、息肉检出率（PDR）和微小（≤5mm）ADR。
共 240 例患者被随机分配至三组，6 例患者退出。234 例评估患者中，78、79 和 77 例分别分配至对照组、PEG-S1 和 PEG-S2 组。所有结肠段的气泡评分在 PEG-S2 组最低。三组间 ADR 或 PDR 无显著差异。然而，PEG-S2 组微小 ADR 显著高于其他两组（对照组 5.1% vs. PEG-S1 8.9% vs. PEG-S2 20.8%；P=0.009）。
在最佳时间向 PEG-Asc 添加二甲硅油可防止气泡形成，从而改善肠道准备质量，特别是提高微小 ADR。
