SYSTEMATIC REVIEW/META ANALYSIS
Year : 2018 | Volume
: 24 | Issue : 6 | Page : 311--316
Water exchange versus air insufflation for colonoscopy: A meta-analysis
Yang Liu, Qing-Ke Huang, Xiu-Li Dong, Piao-Piao Jin
Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
Background/Aims: To compare water exchange (WE) method with conventional air insufflation (AI) method for colonoscopy, evaluating the technical quality, screening efficacy, and patients' acceptance.
Materials and Methods: Electronic databases were systematically searched for randomized controlled trials comparing WE colonoscopy with AI colonoscopy. The pooled data of procedure-associated and patient-related outcomes were assessed, using the weighted mean difference (WMD) with 95% confidence interval (CI) for continuous variables and relative risk (RR) with 95% CI for dichotomous variables, respectively.
Results: A total of 13 studies involving 7056 patients were included. The cecum intubation rate was similar between WE and AI methods (RR = 1.01, 95% CI = 0.99–1.02,P = 0.37); however, a significantly longer cecum intubation time was shown in WE group (WMD = 1.56, 95% CI = 0.75–2.37,P = 0.002). Compared with AI, WE was associated with a higher risk of adenoma detection rate (ADR) (RR = 1.28, 95% CI = 1.18–1.38,P < 0.00001) and polyp detection rate (PDR) (RR = 1.30, 95% CI = 1.21–1.39,P < 0.00001). Patients in WE group experienced significantly less maximum pain score (WMD = −1.99, 95% CI = −2.68 to −1.30,P < 0.00001) and less requested on-demand sedation (RR = 0.58, 95% CI = 0.44–0.77,P = 0.0002). Likewise, they also experienced less abdominal compression (RR = 0.62, 95% CI = 0.51-0.74,P < 0.00001) and reposition (RR = 0.74, 95% CI = 0.63-0.86,P = 0.0001). Moreover, patients' willingness to repeat colonoscopy was significantly greater for WE (RR = 1.14, 95% CI = 1.07–1.21,P < 0.0001).
Conclusion: This meta-analysis confirmed that WE method could significantly increase ADR/PDR and improve patients' acceptance of colonoscopy, while reducing the degree of pain and minimize the need for on-demand sedation and adjunct maneuvers, despite requiring more cecal intubation time.
Dr. Piao-Piao Jin
Department of Gastroenterology and Hepatology, The First Afliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province
|How to cite this article:|
Liu Y, Huang QK, Dong XL, Jin PP. Water exchange versus air insufflation for colonoscopy: A meta-analysis.Saudi J Gastroenterol 2018;24:311-316
|How to cite this URL:|
Liu Y, Huang QK, Dong XL, Jin PP. Water exchange versus air insufflation for colonoscopy: A meta-analysis. Saudi J Gastroenterol [serial online] 2018 [cited 2019 Feb 20 ];24:311-316
Available from: http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2018;volume=24;issue=6;spage=311;epage=316;aulast=Liu;type=0