Abstract
Background
Adequate bowel cleansing is of great importance for a high-quality colonoscopy examination. Nevertheless, whether sodium phosphate or polyethylene glycol is a gold standard agent for bowel preparation is still under debate. In consideration of the clinical needs, we thus performed an updated meta-analysis of randomized controlled trials concerning the comparison between both regimens. The efficacy, safety and acceptability of each regimen are major indicators to measure and appraise.
Methods
By searching PubMed, EMBASE, Web of Science and Cochrane Library databases, 15 original trials published from 2000 to 2014 were included as eligible studies. We carried out data extraction and subsequent pooling analysis for each indicator in a standard manner. Sensitivity analysis was performed by elimination of low-quality trials, while a funnel plot and Egger’s test were employed to analyze the publication bias across studies.
Results
Our pooling analysis revealed that patients undergoing sodium phosphate as a cleansing agent displayed better acceptability, compliance, cleansing scores, preparation taste, polyp detection rate and less adverse effects including nausea, vomiting and abdominal pain (P < 0.05). In terms of procedure time, adequate preparation rate and electrolyte concentration, there was no significant difference between both regimens (P > 0.05). The pooling analysis offered stable conclusions which were verified by our sensitivity analysis. There was no publication bias across studies as a symmetric funnel plot was demonstrated and the result of Egger’s test was P = 0.56.
Conclusions
Regarding preparation efficacy, safety and acceptability, sodium phosphate was a better agent than polyethylene glycol for colonoscopy bowel cleansing, with its advantages of higher efficacy, better tolerability and acceptability as well as comparable safety.
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Acknowledgments
We sincerely thank all participants in our department for methodological assistance.
Funding
This article is supported by Research Fund of Public Welfare in Health Industry, Health and Family Plan Committee of China (No. 201402015).
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Ji Cheng, Kaixiong Tao, Xiaoming Shuai and Jinbo Gao declare that we have no conflict of interest or financial ties to disclose.
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Cheng, J., Tao, K., Shuai, X. et al. Sodium phosphate versus polyethylene glycol for colonoscopy bowel preparation: an updated meta-analysis of randomized controlled trials. Surg Endosc 30, 4033–4041 (2016). https://doi.org/10.1007/s00464-015-4716-6
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DOI: https://doi.org/10.1007/s00464-015-4716-6