Department of General Surgery, Jiujiang City Key Laboratory of Cell Therapy, Jiu Jiang No.1 People's Hospital, No. 48, Taling South Road, Jiujiang City, 332000, Jiangxi Province, China.
Tech Coloproctol. 2024 Aug 13;28(1):99. doi: 10.1007/s10151-024-02981-9.
This study aimed to compare oral sulfate solution (OSS) with polyethylene glycol (PEG) for bowel preparation before colonoscopy.
A literature search was performed on PubMed, Ovid, and Cochrane Databases for randomized clinical trials (RCT) comparing OSS with PEG for bowel preparation before colonoscopy. The last search was performed on 22 August 2023. The primary outcome was the quality of bowel preparation. The outcomes were compared by meta-analysis and trial sequential analysis (TSA).
A total of 14 RCTs with 4526 patients were included. OSS was comparable with PEG regarding adequate bowel preparation [P = 0.16, odds ratio (OR) = 1.19, 95% confidence interval (CI) [0.93, 1.51], I = 0%]. However, OSS showed obvious priority in excellent bowel preparation (P < 0.001, OR = 1.62, 95% CI [1.27, 2.05], I = 0%) and total Boston bowel preparation scale (BBPS) [P = 0.02, weighted mean difference (WMD) = 0.27, 95% CI [0.05, 0.50], I = 84%]. Additionally, the detection rate of polyps (P = 0.001, OR = 1.44, 95% CI [1.15, 1.80], I = 0%) and adenoma (P = 0.007, OR = 1.22, 95% CI [1.06, 1.42], I = 0%) was significantly higher in the OSS group. The two groups showed comparable incidence of adverse events except for a higher incidence of dizziness (P = 0.02, OR = 1.74, 95% CI [1.08, 2.83], I = 11%) was indicated in the OSS group. Moreover, OSS was associated with a higher satisfaction score (P = 0.02, WMD = 0.62, 95% CI [0.09, 1.15], I = 70%). In the TSA, the cumulative Z-curve crossed both the conventional boundary and trial sequential monitoring boundary and the required information size has been reached for excellent bowel preparation and total BBPS.
The current data demonstrated that OSS was associated with better quality of bowel preparation. More clinical trials are still needed to confirm other outcomes.
本研究旨在比较口服硫酸盐溶液（OSS）与聚乙二醇（PEG）在结肠镜检查前的肠道准备中的效果。
对 PubMed、Ovid 和 Cochrane 数据库进行文献检索，以比较 OSS 与 PEG 在结肠镜检查前肠道准备中的随机临床试验（RCT）。最后一次检索时间为 2023 年 8 月 22 日。主要结局是肠道准备的质量。采用荟萃分析和试验序贯分析（TSA）比较结局。
共纳入 14 项 RCT，涉及 4526 例患者。OSS 在充分的肠道准备方面与 PEG 相当[P=0.16，比值比（OR）=1.19，95%置信区间（CI）[0.93, 1.51]，I²=0%]。然而，OSS 在优秀的肠道准备方面具有明显的优势（P<0.001，OR=1.62，95%CI[1.27, 2.05]，I²=0%）和总波士顿肠道准备量表（BBPS）[P=0.02，加权均数差（WMD）=0.27，95%CI[0.05, 0.50]，I²=84%]。此外，OSS 组息肉（P=0.001，OR=1.44，95%CI[1.15, 1.80]，I²=0%）和腺瘤（P=0.007，OR=1.22，95%CI[1.06, 1.42]，I²=0%）的检出率明显更高。两组的不良反应发生率相当，但 OSS 组头晕的发生率较高（P=0.02，OR=1.74，95%CI[1.08, 2.83]，I²=11%）。此外，OSS 组的满意度评分较高（P=0.02，WMD=0.62，95%CI[0.09, 1.15]，I²=70%）。在 TSA 中，累积 Z 曲线穿过了常规边界和试验序贯监测边界，并且达到了优秀肠道准备和总 BBPS 的所需信息量。
目前的数据表明，OSS 与更好的肠道准备质量相关。仍需要更多的临床试验来证实其他结局。
