Caccia Riccardo, Rimondi Alessandro, Elli Luca, Topa Matilde, Cavallaro Flaminia, Gentile Carmine, Scaramella Lucia, Nandi Nicoletta, Sidhu Reena, Eidler Pinhas, Vecchi Maurizio, Tontini Gian Eugenio
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Clin Endosc. 2025 Mar;58(2):285-290. doi: 10.5946/ce.2024.097. Epub 2025 Jan 2.
BACKGROUND/AIMS: Optimization of bowel preparation for small bowel capsule endoscopy (SBCE) is debated. Guidelines recommend 2 L of iso-osmolar polyethylene glycol (PEG) to improve SBCE visibility. We compared the efficacy of the standard 2 L PEG solution with a 1 L PEG plus ascorbate (PEG-ASC) preparation, which has already been established for large-bowel preparation.
Between October 2020 and February 2022, patients undergoing SBCE were assigned to receive 2 L PEG or 1 L PEG-ASC bowel preparation on an even- or odd-day basis. Bowel cleanliness was evaluated using the small bowel mucosal visibility scoring system (SBMVSS).
Following propensity score matching using a random forest method, two comparable populations of patients treated with 2 L PEG (n=74, male 41%, 53±17 years) and 1 L PEG-ASC (n=74, male 42%, 55±21 years) were obtained from the original cohort of 221 consecutive SBCE patients. Our results showed a trend towards more frequent adequate mucosal visibility with 1 L PEG-ASC compared to 2 L PEG (small bowel mucosal visibility ≥2 in all three small bowel tertiles, p=0.07), as per the SBMVSS score. No significant differences were observed in the diagnostic yield (p=1.00), visibility score=9 (p=0.85), SBCE completeness (p=0.33), or adequate mucosal visibility in each tertile (p=0.61, p=0.74, and p=0.70 for the first, second, and third tertiles, respectively).
Our study suggests the non-inferiority of the 1 L PEG-ASC solution over the standard 2 L PEG for SBCE preparation.
背景/目的：小肠胶囊内镜检查（SBCE）肠道准备的优化存在争议。指南推荐使用2升等渗聚乙二醇（PEG）以提高SBCE的可视性。我们比较了标准的2升PEG溶液与1升PEG加抗坏血酸盐（PEG-ASC）制剂的效果，后者已被用于大肠准备。
在2020年10月至2022年2月期间，接受SBCE的患者按偶数日或奇数日分配接受2升PEG或1升PEG-ASC肠道准备。使用小肠黏膜可视性评分系统（SBMVSS）评估肠道清洁度。
通过随机森林方法进行倾向评分匹配后，从221例连续SBCE患者的原始队列中获得了两组可比的患者群体，分别为接受2升PEG治疗的患者（n = 74，男性占41%，53±17岁）和接受1升PEG-ASC治疗的患者（n = 74，男性占42%，55±21岁）。根据SBMVSS评分，我们的结果显示，与2升PEG相比，1升PEG-ASC组黏膜可视性充足的频率有增加趋势（在所有三个小肠三分位中，小肠黏膜可视性≥2，p = 0.07）。在诊断率（p = 1.00）、可视性评分=9（p = 0.85）、SBCE完整性（p = 0.33）或每个三分位中的黏膜可视性充足情况（第一、第二和第三三分位分别为p = 0.61、p = 0.74和p = 0.70）方面未观察到显著差异。
我们的研究表明，对于SBCE准备，1升PEG-ASC溶液不劣于标准的2升PEG溶液。
