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Effect of supplemental simethicone for bowel preparation on adenoma detection during colonoscopy: A meta‐analysis of randomized controlled trials
Author(s) -
Pan Peng,
Zhao ShengBing,
Li BingHan,
Meng QianQian,
Yao Jun,
Wang Dong,
Li ZhaoShen,
Bai Yu
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14401
Subject(s) - colonoscopy , medicine , randomized controlled trial , meta analysis , confidence interval , gastroenterology , adenoma , cochrane library , subgroup analysis , relative risk , bowel preparation , colorectal cancer , cancer
Background and Aim Although several randomized controlled trials (RCTs) have reported that supplemental simethicone (SIM) can improve bowel preparation based on polyethylene glycol, there is no consensus as to whether SIM can ultimately increase the adenoma detection rate (ADR) during colonoscopy. A meta‐analysis was performed to assess the effect of SIM on ADR during colonoscopy. Methods Databases including PubMed, EMBASE, and the Cochrane Library were searched to find relevant RCTs. RCTs evaluating the effect of pre‐procedure SIM on the ADR during colonoscopy were finally included, and fixed effect models were applied. Results Six trials involving 1855 patients were finally included. The present meta‐analysis suggested that the ADR during colonoscopy was significantly increased by supplemental SIM (27.9% vs 23.3%, P = 0.02), with a relative risk of 1.20 (95% confidence interval 1.03–1.39). Subgroup analysis suggested that supplemental SIM may be more useful to improve ADR during colonoscopy in endoscopic centers with low baseline ADR. Conclusions Supplemental SIM for bowel preparation based on polyethylene glycol is useful to improve the ADR during colonoscopy.