Ramos Josué Aliaga, Carvalho Danilo, Arantes Vitor N
Department of Gastroenterology, Hospital "José Agurto Tello-Chosica", Gastroenterology Service "Madre Zoraida" Clinic, Digestive Endoscopy Unit of San Pablo Clinic, Lima, Peru.
Endoscopy Unit, Alfa Institute of Gastroenterology, Belo Horizonte, Brazil.
Clin Endosc. 2024 Nov;57(6):775-782. doi: 10.5946/ce.2024.056. Epub 2024 Oct 22.
BACKGROUND/AIMS: Polyethylene glycol (PEG) is considered the gold standard regimen for bowel preparation; however, due to the necessity of a large volume, patient tolerance is impaired. Therefore, lactulose is a novel alternative for colonoscopy preparation. This study aimed to investigate the efficacy and safety of lactulose-based bowel preparations in comparison with PEG for colonoscopy.
This is a prospective, non-blinded, comparative study. Outpatients were randomly divided into two groups: group 1 (111 patients), PEG; and group 2 (111 patients), lactulose. The following clinical outcomes were assessed in each group: degree of bowel clearance using the Boston bowel preparation score, colorectal polyp detection rate, adenoma detection rate, tolerability, and side effects.
The rate of inadequate bowel preparation was 8.1% and 1.8% for the PEG and lactulose groups, respectively (p=0.030). The Boston bowel preparation score for the entire colon was 7.34±1.17 and 8.36±1.09 for the PEG and lactulose groups, respectively (p<0.001). The satisfactory overall experience rates were 27.9% and 62.2% for the PEG and lactulose groups, respectively (p<0.001).
The novel bowel preparation with oral lactulose was superior to that with PEG in terms of colon cleansing, adenoma detection rate, tolerance, and patient experience.
背景/目的：聚乙二醇（PEG）被认为是肠道准备的金标准方案；然而，由于需要大量使用，患者耐受性较差。因此，乳果糖是结肠镜检查准备的一种新型替代方案。本研究旨在比较基于乳果糖的肠道准备与PEG用于结肠镜检查的有效性和安全性。
这是一项前瞻性、非盲、对照研究。门诊患者随机分为两组：第1组（111例患者），使用PEG；第2组（111例患者），使用乳果糖。评估每组的以下临床结果：使用波士顿肠道准备评分评估肠道清洁程度、结直肠息肉检出率、腺瘤检出率、耐受性和副作用。
PEG组和乳果糖组肠道准备不充分的发生率分别为8.1%和1.8%（p = 0.030）。PEG组和乳果糖组整个结肠的波士顿肠道准备评分分别为7.34±1.17和8.36±1.09（p < 0.001）。PEG组和乳果糖组总体满意度分别为27.9%和62.2%（p < 0.001）。
口服乳果糖的新型肠道准备在结肠清洁、腺瘤检出率、耐受性和患者体验方面优于PEG。
