Meta-Analysis
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2021; 9(15): 3607-3622
Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3607
Effect of antifoaming agent on benign colorectal tumors in colonoscopy: A meta-analysis
Hu Zhang, Jing Gong, Lin-Song Ma, Ting Jiang, Heng Zhang
Hu Zhang, Jing Gong, Lin-Song Ma, Ting Jiang, Heng Zhang, Department of Gastroenterology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, Hubei Province, China
Hu Zhang, Department of Gastroenterology, The Eighth Hospital of Wuhan, Wuhan 430014, Hubei Province, China
Author contributions: Heng Z designed this study and critically revised the manuscript; Hu Z and JL were responsible for data acquisition and extraction; Hu Z drafted the manuscript, analyzed the data, and interpreted the results; Hu Z, Ma LS, Jiang T, and Gong J were involved in editing the manuscript; All authors read and approved the final manuscript.
Supported by the Natural Science Foundation of Wuhan, No. WX18Y04.
Conflict-of-interest statement: All of the authors declare that they have no conflicts of interest regarding this paper.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist statement, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Heng Zhang, MA, MD, Chief Doctor, Department of Gastroenterology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26 Shengli Street, Jiangan District, Wuhan 430014, Hubei Province, China. 653262549@qq.com
Received: January 3, 2021
Peer-review started: January 3, 2021
First decision: February 11, 2021
Revised: February 25, 2021
Accepted: March 12, 2021
Article in press: March 12, 2021
Published online: May 26, 2021
Processing time: 127 Days and 23.4 Hours
Abstract
BACKGROUND

Although several trials have shown that the addition of antifoaming agents to polyethylene glycol (PEG) can improve bowel preparation, whether PEG plus antifoaming agents have a beneficial role in the detection of benign tumors during colonoscopy has yet to be confirmed. Our aim was to clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors.

AIM

To clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors.

METHODS

The PubMed, EMBASE, and Cochrane Library databases were searched for articles published prior to September 2019. The outcomes included the detection rates of colorectal adenomas and polyps.

RESULT

Twenty studies were eligible. Although there was no difference in the colorectal adenoma detection rate (ADR), a significant effect of simethicone for diminutive adenomas (< 10 mm) was revealed in the group taking simethicone. We also found that simethicone could significantly improve the ADR in the proximal colon but did not affect the colorectal polyp detection rate. Furthermore, the subgroup analyses revealed a beneficial effect of simethicone on the ADR among Asians (P = 0.005) and those with an ADR < 25% (P = 0.003). Moreover, it was a significant finding that the low dose simethicone was as effective as the high dose one with respect to the detection of benign colorectal tumors.

CONCLUSION

In summary, the addition of simethicone to PEG might improve the detection of diminutive adenomas in the right colon by colonoscopy in Asia. Low-dose simethicone was recommended for the detection of benign colorectal tumors. However, large clinical trials are necessary to validate our results and determine the ideal dose of simethicone.

Keywords: Antifoaming agent; Simethicone; Polyethylene glycol; Colonoscopy; Meta-analysis

Core Tip: The addition of simethicone to polyethylene glycol might improve the detection of diminutive adenomas in the right colon by colonoscopy in Asia. Low-dose simethicone was recommended for the detection of benign colorectal tumors.