ArticleTherapeutic advances in gastroenterology2026
Abdominal binders improve colonoscopy outcomes: a systematic review and meta-analysis of randomized controlled trials with BMI-stratified subgroup analysis.
Article in Therapeutic advances in gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Abdominal binders have been studied as an adjunctive device for colonoscopy, but trial-level evidence is heterogeneous and existing meta-analyses have either not stratified by body-mass index (BMI) or used only linear meta-regression, leaving BMI dependence of binder benefit unresolved. Objectives: To quantify the effect of abdominal binders on cecal intubation time (CIT), post-procedural pain, manual pressure, and position change during adult colonoscopy and to examine BMI dependence using a pre-specified stratified approach. Design: Systematic review and meta-analysis of randomized controlled trials. Methods: Seven academic databases plus ClinicalTrials.gov were searched (primary April 30, 2025; updated February 28, 2026). Two reviewers screened records and assessed risk of bias (Cochrane RoB 2) independently. Effects were pooled with random-effects (DerSimonian-Laird) models: mean difference (CIT), Hedges's Results: Fourteen RCTs ( Conclusion: Abdominal binders consistently improve four colonoscopy-related outcomes; the non-monotonic BMI response pattern suggests two distinct mechanistic pathways and is hypothesis-generating, warranting confirmation in BMI-stratified randomized trials. Trial registration: Prospectively registered with International Platform of Registered Systematic Review and Meta-Analysis Protocols on May 15, 2025 (registration number INPLASY202550043; DOI: 10.37766/inplasy2025.5.0043).
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