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Randomized Trial Comparing Left Colon Mucus Production Using Water vs Saline During Water Exchange Colonoscopy.
Cheng, Chi-Liang; Kuo, Yen-Lin; Liu, Nai-Jen; Lien, Jau-Min; Su, I-Chia; Tang, Chia-Pei; Hsieh, Yu-Hsi; Leung, Felix W.
Afiliación
  • Cheng CL; Division of Gastroenterology, Evergreen General Hospital, Taoyuan, Taiwan.
  • Kuo YL; Division of Gastroenterology, Evergreen General Hospital, Taoyuan, Taiwan.
  • Liu NJ; Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Lien JM; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Su IC; Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  • Tang CP; Division of Gastroenterology, Evergreen General Hospital, Taoyuan, Taiwan.
  • Hsieh YH; Division of Gastroenterology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
  • Leung FW; Division of Gastroenterology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
Clin Transl Gastroenterol ; 14(7): e00594, 2023 07 01.
Article en En | MEDLINE | ID: mdl-37141104
INTRODUCTION: Water-assisted colonoscopy increases left colon mucus production; however, the effect of saline on mucus production is unclear. We tested the hypothesis that saline infusion may reduce mucus production in a dose-related manner. METHODS: In a randomized trial, patients were assigned to colonoscopy with CO 2 insufflation, water exchange (WE) with warm water, 25% saline, or 50% saline. The primary outcome was the Left Colon Mucus Scale (LCMS) score (5-point scale). Blood electrolytes were measured before and after saline infusion. RESULTS: A total of 296 patients with similar baseline demographics were included. The mean LCMS score for WE with water was significantly higher than that for WE with saline and CO 2 (1.4 ± 0.8 [WE water] vs 0.7 ± 0.6 [WE 25% saline] vs 0.5 ± 0.5 [WE 50% saline] vs 0.2 ± 0.4 [CO 2 ]; overall P < 0.0001), with no significant difference between the 25% and 50% saline groups. The left colon adenoma detection rate (ADR) was highest in the 50% saline group, followed by the 25% saline and the water groups (25.0% vs 18.7% vs 13.3%), but the difference was not significant. Logistic regression showed water infusion as the only predictor of moderate mucus production (odds ratio 33.3, 95% confidence interval 7.2-153.2). No acute electrolyte abnormalities were documented indicating a safe modification. DISCUSSION: The use of 25% and 50% saline significantly inhibited mucus production and numerically increased ADR in the left colon. Evaluation of the impact of mucus inhibition by saline on ADR may refine the outcomes of WE.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Adenoma / Neoplasias del Colon Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Clin Transl Gastroenterol Año: 2023 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Adenoma / Neoplasias del Colon Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Clin Transl Gastroenterol Año: 2023 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Estados Unidos