SynthesisSaudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association
Water exchange versus air insufflation for colonoscopy: A meta-analysis.
Synthesis in Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Clinical value of sigmoid colon water exchange colonoscopy: a prospective randomized clinical trial.Scientific reports · 2023Trial
- Protocol design for randomized clinical trial to compare underwater cold snare polypectomy to conventional cold snare polypectomy for non-pedunculated colon polyps of size 5-10 mm (COLDWATER study).Techniques in coloproctology · 2023Article
- Colonoscopy skills improvement training improves patient comfort during colonoscopy.Surgical endoscopy · 2022Article
- Optical imaging technology in colonoscopy: Is there a role for photometric stereo?World journal of gastrointestinal endoscopy · 2020Review
- Comparison of application value between conventional air insufflation and water infusion in colonoscopy.International journal of clinical and experimental pathology · 2020Article
- A review of water exchange and artificial intelligence in improving adenoma detection.Tzu chi medical journalReview
- Water exchange versus air insufflation for colonoscopy: Methodological issues of the meta-analysis are a cause for concern.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology AssociationArticle
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimsTo compare water exchange (WE) method with conventional air insufflation (AI) method for colonoscopy, evaluating the technical quality, screening efficacy, and patients' acceptance. MATERIALS AND
methodsElectronic databases were systematically searched for randomized controlled trials comparing WE colonoscopy with AI colonoscopy. The pooled data of procedure-associated and patient-related outcomes were assessed, using the weighted mean difference (WMD) with 95% confidence interval (CI) for continuous variables and relative risk (RR) with 95% CI for dichotomous variables, respectively.
resultsA total of 13 studies involving 7056 patients were included. The cecum intubation rate was similar between WE and AI methods (RR = 1.01, 95% CI = 0.99-1.02,P = 0.37); however, a significantly longer cecum intubation time was shown in WE group (WMD = 1.56, 95% CI = 0.75-2.37,P = 0.002). Compared with AI, WE was associated with a higher risk of adenoma detection rate (ADR) (RR = 1.28, 95% CI = 1.18-1.38,P < 0.00001) and polyp detection rate (PDR) (RR = 1.30, 95% CI = 1.21-1.39,P < 0.00001). Patients in WE group experienced significantly less maximum pain score (WMD = -1.99, 95% CI = -2.68 to -1.30,P < 0.00001) and less requested on-demand sedation (RR = 0.58, 95% CI = 0.44-0.77,P = 0.0002). Likewise, they also experienced less abdominal compression (RR = 0.62, 95% CI = 0.51-0.74,P < 0.00001) and reposition (RR = 0.74, 95% CI = 0.63-0.86,P = 0.0001). Moreover, patients' willingness to repeat colonoscopy was significantly greater for WE (RR = 1.14, 95% CI = 1.07-1.21,P < 0.0001).
conclusionThis meta-analysis confirmed that WE method could significantly increase ADR/PDR and improve patients' acceptance of colonoscopy, while reducing the degree of pain and minimize the need for on-demand sedation and adjunct maneuvers, despite requiring more cecal intubation time.
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