Meta-Analysis
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World J Gastroenterol. Nov 7, 2013; 19(41): 7197-7204
Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.7197
Magnetic endoscopic imaging vs standard colonoscopy: Meta-analysis of randomized controlled trials
Yi Chen, Yu-Ting Duan, Qin Xie, Xian-Peng Qin, Bo Chen, Lin Xia, Yong Zhou, Ning-Ning Li, Xiao-Ting Wu
Yi Chen, Bo Chen, Lin Xia, Xian-Peng Qin, Yong Zhou, Ning-Ning Li, Xiao-Ting Wu, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yu-Ting Duan, Department of Radiology, People’s Hospital, Liaocheng 252000, Shandong Province, China
Qin Xie, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Chen Y designed the study; Chen Y, Chen B and Qin XP performed the research; Duan YT, Xia L and Wu XT contributed analytical tools; Zhou Y and Li NN analyzed the data; Chen Y and Xie Q wrote the manuscript.
Supported by The National Natural Science Foundation of China, No. 81172374; Sichuan Provincial Science and Technology Department Application Infrastructure Plan, No. 2013JY0154
Correspondence to: Xiao-Ting Wu, MD, PhD, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Guoxuexiang No. 37, Chengdu 610041, Sichuan Province, China. wuxiaoting1975@gmail.com
Telephone: +86-28-85422872 Fax: +86-28- 85422872
Received: May 20, 2013
Revised: August 30, 2013
Accepted: September 3, 2013
Published online: November 7, 2013
Abstract

AIM: To assess the theoretical advantages of magnetic endoscope imaging (MEI) over standard colonoscopies (SCs) and to compare their efficacies.

METHODS: Electronic databases, including PubMed, EMBASE, the Cochrane library and the Science Citation Index, were searched to retrieve relevant trials. In addition, abstracts from papers presented at professional meetings and the reference lists of retrieved articles were reviewed to identify additional studies. The meta-analyses were performed using RevMan 5.1. A random effect model with the Mantel-Haenszel method was used for pooling dichotomous and continuous data. A sensitivity analysis was performed by excluding the trials with a small number of patients and by excluding the trials performed by inexperienced providers.

RESULTS: Eight randomized controlled trials (RCTs), including 2967 patients, were included in the meta-analysis to compare cecal intubation rates and times, sedation dose, abdominal pain scores and the use of ancillary maneuvers between MEI and SC. The overall OR was 1.92 (95%CI: 1.13-3.27, eight RCTs), as indicated by the cecal intubation rate of MEI compared with SC, but MEI did not have any distinct advantage over SC for cecal intubation time (MD = -0.07, 95%CI: -0.16-0.02; three RCTs). MEI did not generally result in lower pain scores. Outcomes were also analyzed for the two subgroups based on the endoscopists’ experience level to evaluate cecal intubation rates. MEI presented better outcomes for non-experienced colonoscopists than experienced colonoscopists.

CONCLUSION: The real-time magnetic imaging system is of benefit in training and educating inexperienced endoscopists and improves the cecal intubation rate for experienced and inexperienced endoscopists.

Keywords: Colonoscope, Magnetic endoscope imaging, Magnetic, Standard colonoscope, Meta-analysis

Core tip: This study aimed to assess the theoretical advantages of magnetic endoscopic imaging (MEI) over standard colonoscopy (SC) and to compare the efficacies of MEI and SC. The meta-analyses compared the cecal intubation rate and time, sedation dose used, abdominal pain scores and the use of ancillary maneuvers between MEI and SC. The real-time magnetic imaging system is of benefit in training and educating inexperienced endoscopists, and it improved the cecal intubation rate for both experienced and inexperienced endoscopists.