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sodium picosulphate or polyethylene glycol before elective colonoscopy in outpatients?A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2018年第12期10卷 422-441页

作者： Rodrigo Silva de Paula Rocha Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura Wanderley Marques Bernardo Maurício Kazuyoshi Minata Flávio Hiroshi Ananias Morita Júlio Cesar Martins Aquino Elisa Ryoka Baba Nelson Tomio Miyajima Eduardo Guimaraes Hourneaux de Moura Gastrointestinal Endoscopy Unit Hospital das Cliicas da Faculdade de Medicina da Universidade de Sao PauloSao Paulo 05403-010Brazil Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115United States

AIM To determine the best option for bowel preparation [sodium picosulphate or polyethylene glycol(PEG)] for elective colonoscopy in adult *** A systematic review of the literature following the PRISMA guidelines was performed using Medline, Scopus, EMBASE, Central, Cinahl and Lilacs. No restrictions were placed for country, year of publication or language. The last search in the literature was performed on November 20th, 2017. Only randomized clinical trials with full texts published were included. The subjects included were adult outpatients who underwent bowel cleansing for elective colonoscopy. The included studies compared sodium picosulphate with magnesium citrate(SPMC)and PEG for bowel preparation. Exclusion criteria were the inclusion of inpatients or groups with specific conditions, failure to mention patient status(outpatient or inpatient) or dietary restrictions, and permission to have unrestricted diet on the day prior to the exam. Primary outcomes were bowel cleaning success and/or tolerability of colon preparation. Secondary outcomes were adverse events, polyp and adenoma detection rates. Data on intention-totreat were extracted by two independent authors and risk of bias assessed through the Jadad scale. Funnel plots, Egger's test, Higgins' test(I2) and sensitivity analyses were used to assess reporting bias and heterogeneity. The meta-analysis was performed by computing risk difference(RD) using MantelHaenszel(MH) method with fixed-effects(FE) and random-effects(RE) *** Manager 5(RevMan 5) version 6.1(The Cochrane Collaboration) was the software chosen to perform the ***662 records were identified but only 16 trials with 6200 subjects were included for the meta-analysis. High heterogeneity among studies was found and sensitivity analysis was needed and performed to interpret data. In the pooled analysis,SPMC was better for bowel cleaning [MH FE, RD 0.03, IC(0.01, 0.05), P = 0.003, I2= 33%, NNT 34], for tole

关键词： sodium picosulphate Polyethylene glycol Bowel cleaning success Tolerability Colonoscopy Randomized clinical trials Meta-analysis

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