Effectiveness of premedication with pronase for improving visibility during gastroendoscopy: a randomized controlled trial.
BACKGROUND
Minute early gastric cancers can be removed with endoscopic mucosal resection techniques. However, early detection of these minute cancers with endoscopy is still difficult. For this purpose, use of a dye is helpful. To increase visibility further, gastric mucus should be removed before endoscopic examination. In this study, the effectiveness of premedication with pronase for improving visibility during gastroendoscopy was investigated.


METHODS
From January through July 1996, outpatients scheduled for gastroendoscopy were randomly assigned to oral premedication with the antifoam agent dimethylpolysiloxane alone (n=34), with dimethylpolysiloxane plus sodium bicarbonate (n=32), or with dimethylpolysiloxane, sodium bicarbonate, and pronase (n=34). All were given about 10 minutes before the start of endoscopy. After inserting the endoscope, the endoscopist gave visibility scores at conventional endoscopy and after methylene blue spraying.


RESULTS
Premedication with pronase significantly improved visibility before and after methylene blue spraying as compared with the two other groups pretreated without pronase. Pronase also significantly shortened the times for chromoendoscopic examination. Pronase had no significant effect on the culture of Helicobacter pylori.


CONCLUSIONS
Premedication with pronase improved endoscopic visualization during conventional endoscopy and chromoendoscopy. Its routine use at gastroendoscopy is therefore recommended.
Fujii
T
T
Department of Nursing, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Iishi
H
H
Tatsuta
M
M
Hirasawa
R
R
Uedo
N
N
Hifumi
K
K
Omori
M
M
D000328:Adult; D003937:Diagnosis, Differential; D004129:Dimethylpolysiloxanes; D005260:Female; D005756:Gastritis / Q000175:diagnosis; D005773:Gastroscopy / Q000379:methods*; D016481:Helicobacter Infections / Q000175:diagnosis; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D011292:Premedication; D011402:Pronase; D012680:Sensitivity and Specificity; D017693:Sodium Bicarbonate; D013274:Stomach Neoplasms / Q000175:diagnosis; D013276:Stomach Ulcer / Q000175:diagnosis
D004129:Dimethylpolysiloxanes; D017693:Sodium Bicarbonate; D011402:Pronase; D008751:Methylene Blue