title: A meta-analysis of randomized controlled trials of low-volume polyethylene glycol plus ascorbic acid versus standard-volume polyethylene glycol solution as bowel preparations for colonoscopy.
abstract: BACKGROUND
  Standard-volume polyethylene glycol (PEG) gut lavage solutions are safe and effective, but they require the consumption of large volumes of fluid. A new lower-volume solution of PEG plus ascorbic acid has been used recently as a preparation for colonoscopy.
  
  
  OBJECTIVE
  A meta-analysis was performed to compare the performance of low-volume PEG plus ascorbic acid with standard-volume PEG as bowel preparation for colonoscopy.
  
  
  METHODS
  Electronic and manual searches were performed to identify randomized controlled trials (RCTs) that compared the performance of low-volume PEG plus ascorbic acid with standard-volume PEG as bowel preparation for colonoscopy. After a methodological quality assessment and data extraction, the pooled estimates of bowel preparation efficacy during bowel cleansing, compliance with preparation, willingness to repeat the same preparation, and the side effects were calculated. We calculated pooled estimates of odds ratios (OR) by fixed- and/or random-effects models. We also assessed heterogeneity among studies and the publication bias.
  
  
  RESULTS
  Eleven RCTs were identified for analysis. The pooled OR for preparation efficacy during bowel cleansing and for compliance with preparation for low-volume PEG plus ascorbic acid were 1.08 (95% CI = 0.98-1.28, P = 0.34) and 2.23 (95% CI = 1.67-2.98, P<0.00001), respectively, compared with those for standard-volume PEG. The side effects of vomiting and nausea for low-volume PEG plus ascorbic acid were reduced relative to standard-volume PEG. There was no significant publication bias, according to a funnel plot.
  
  
  CONCLUSIONS
  Low-volume PEG plus ascorbic acid gut lavage achieved non-inferior efficacy for bowel cleansing, is more acceptable to patients, and has fewer side effects than standard-volume PEG as a bowel preparation method for colonoscopy.
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Qingsong
authors.initials: Q
authors.lastname: Xie
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Linghui
authors.initials: L
authors.lastname: Chen
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Fengqing
authors.initials: F
authors.lastname: Zhao
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Xiaohu
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Huang
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Lufei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Dongkai
authors.initials: D
authors.lastname: Zhou
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Wei
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Weilin
authors.initials: W
authors.lastname: Wang
authors.affiliation: Division of Hepatobilitary and Pancreatic Surgery, Department of surgery, First affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Hangzhou, Zhejiang Province, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, Zhejiang Province, China.
authors.forename: Shusen
authors.initials: S
authors.lastname: Zheng
mesh_terms: D001205:Ascorbic Acid / Q000627:therapeutic use*; D002400:Cathartics / Q000009:adverse effects / Q000627:therapeutic use*; D003113:Colonoscopy; D016208:Databases, Factual; D006801:Humans; D009325:Nausea / Q000209:etiology; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D014839:Vomiting / Q000209:etiology
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols; D001205:Ascorbic Acid