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Evaluating a combined bowel preparation for small-bowel capsule endoscopy: a prospective randomized–controlled study

机译:评估小肠胶囊内窥镜检查的组合肠道准备:预期随机对照研究

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BackgroundCapsule endoscopy (CE) is frequently hindered by intra-luminal debris. Our aim was to determine whether a combination bowel preparation would improve small-bowel visualization, diagnostic yield, and the completion rate of CE.MethodsSingle-blind, prospective randomized–controlled study of outpatients scheduled for CE. Bowel-preparation subjects ingested 2?L of polyethylene glycol solution the night prior to CE, 5?mL simethicone and 5?mg metoclopramide 20?minutes prior to CE and laid in the right lateral position 30?minutes after swallowing CE. Controls had no solid food after 7 p.m. the night prior to CE and no liquids 4?hours prior to CE. Participants completed a satisfaction survey. Capsule readers completed a small-bowel-visualization assessment.ResultsFifty patients were prospectively enrolled (56% female) with a median age of 54.4?years and 44 completed the study (23 patients in the control group and 21 in the preparation group). There was no significant difference between groups on quartile-based small-bowel visualization (all P??0.05). There was no significant difference between groups in diagnostic yield (P?=?0.69), mean gastric (P?=?0.10) or small-bowel transit time (P?=?0.89). The small-bowel completion rate was significantly higher in the preparation group (100% vs 78%; P?=?0.02). Bowel-preparation subjects reported significantly more discomfort than controls (62% vs 17%; P?=?0.01).ConclusionsCombined bowel preparation did not improve small-bowel visualization but did significantly increase patient discomfort. The CE completion rate improved in the preparation group but the diagnostic yield was unaffected. Based on our findings, a bowel preparation prior to CE does not appear to improve CE performance and results in decreased patient satisfaction (ClinicalTrials.gov, No. NCT01243736).
机译:背景包括内窥镜检查(CE)经常受到腔内碎片的阻碍。我们的目的是确定组合肠道准备是否会提高小肠可视化,诊断产量和CE.Methodssingle-Drint的完井率,预定调度的门诊患者的前瞻性随机对照研究。肠道制备受试者在Ce,5?ml Simethicone之前的夜晚摄取2·L聚乙二醇溶液,在CE之前的20℃,吞咽右侧位置30?分钟。在下午7点后,对照没有固体食物。在CE之前的夜晚,在CE之前没有液体4?小时。参与者完成了满意度调查。胶囊读者完成了一个小肠可视化评估。患者患者前瞻性纳入(56%的女性),中位年龄为54.4岁,40岁,44岁(23名患者在对照组中,制备组中21例)。基于四分位数的小肠可视化(所有P?> 0.05)之间没有显着差异。诊断产率之间没有显着差异(p?= 0.69),平均胃(p?= 0.10)或小肠过渡时间(p?= 0.89)。制备组的小肠完井率明显高(100%vs 78%; p?= 0.02)。肠道制备受试者报告比对照的更大不适(62%vs 17%; p?= 0.01)。ConclusionsCombined的肠道制剂没有改善小肠可视化,但确实显着提高了患者的不适。 CE完成率在制备组中得到改善,但诊断产量不受影响。基于我们的研究结果,CE之前的肠道准备似乎没有改善CE性能,并导致患者满意度降低(Clinicaltrials.gov,No.Nod01243736)。

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