Pan H, Zheng XL, Fang CY, Liu LZ, Chen JS, Wang C, Chen YD, Huang JM, Zhou YS, He LP. Same-day single-dose vs large-volume split-dose regimens of polyethylene glycol for bowel preparation: A systematic review and meta-analysis. World J Clin Cases 2022; 10(22): 7844-7858 [PMID: 36158495 DOI: 10.12998/wjcc.v10.i22.7844]
Corresponding Author of This Article
Xiao-Ling Zheng, MD, PhD, Chief Physician, Professor, Gastrointestinal Endoscopy Center, The Shengli Clinical Medical College, Fujian Medical University, No. 134 Dong Street, Gulou District, Fuzhou 350001, Fujian Province, China. shengli888220@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Hui Pan, Xiao-Ling Zheng, Gastrointestinal Endoscopy Center, Fujian Provincial Hospital, The Shengli Clinical Medical College, Fujian Medical University, Fuzhou 350001, Fujian Province, China
Chao-Ying Fang, Lan-Zai Liu, Jian-Su Chen, Chao Wang, Yu-Dai Chen, Jian-Min Huang, Yu-Shen Zhou, Li-Ping He, Gastrointestinal Endoscopy Center, Fujian Provincial Hospital South Branch, Fuzhou 350001, Fujian Province, China
Author contributions: Pan H, Fang CY, Chen JS and Wang C contributed to data curation and writing the original draft; Zheng XL and Pan H contributed to the methodology; Zheng XL, Pan H and Fang CY contributed to the project administration; Chen YD, Huang JM and Zhou YS contributed to the supervision; Zheng XL and He LP contributed to the writing, reviewing and editing; all authors have read and approved the final manuscript.
Supported byStartup Fund for scientific research, Fujian Medical University, No. 2019QH1181.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Ling Zheng, MD, PhD, Chief Physician, Professor, Gastrointestinal Endoscopy Center, The Shengli Clinical Medical College, Fujian Medical University, No. 134 Dong Street, Gulou District, Fuzhou 350001, Fujian Province, China. shengli888220@163.com
Received: September 8, 2021 Peer-review started: September 8, 2021 First decision: December 4, 2021 Revised: December 11, 2021 Accepted: June 27, 2022 Article in press: June 27, 2022 Published online: August 6, 2022 Processing time: 316 Days and 17.8 Hours
ARTICLE HIGHLIGHTS
Research background
High volume (4 L) split-dose regimens (SpDs) of polyethylene glycol (PEG) have been recommended as the gold-standard regimen for bowel preparation, but its large volume of fluids and poor tolerability have become sources of patient dissatisfaction.
Research motivation
The same-day single-dose (SSD) PEG has been recommended as an alternative for bowel preparation. However, its superiority compared to other regimens is a matter of debate.
Research objectives
To seek one PEG-based regimen for bowel preparation with characteristics of equal cleansing efficacy, reducing the preparation volume and improving patient tolerance.
Research methods
We conducted a systematic review and meta-analysis to compare the efficacy and tolerability of SSD PEG-based arm vs large-volume (≥ 3 L) SpDs PEG solutions for bowel preparation before colonoscopy, regardless of adjuvant laxative use.
Research results
A total of 18 studies were included. There was no statistically significant difference of adequate bowel preparation, right colon Boston Bowel Preparation Scale and right colon Ottawa Bowel Preparation Scale between (2 L/4 L) SSDs and large-volume (4 L/3 L) SpDs, regardless of adjuvant laxative use. The use of SSDs had advantages of less sleep disturbance and lower incidence of abdominal pain. Patients that received low-volume (2 L) SSDs showed more willingness to repeat the procedure than patients receiving SpDs (P < 0.05).
Research conclusions
Regardless of adjuvant laxative use, the (2 L/4 L) SSDs PEG-based arm was considered equal or better than the large-volume (≥ 3 L) SpDs PEG regimen in terms of bowel cleanliness and tolerability.
Research perspectives
Given its efficacy and tolerability, the low-volume (2 L) SSD PEG regimen has huge prospects as a superior alternative to SpDs regimens as long as the optimal preparation-to-colonoscopy interval and dietary instructions for bowel preparation are respected.
