title: 3-L split-dose is superior to 2-L polyethylene glycol in bowel cleansing in Chinese population: a multicenter randomized, controlled trial.
abstract: Large volume (4 L) of polyethylene glycol (PEG) solution would ensure a better quality of bowel cleansing but might be poorly tolerated. Due to the smaller body size, lower body weight, and different diet habits, the large volume of 4-L PEG might be poorly tolerated by the Chinese population. In view of this, a balance should be made between the volume and effectiveness. This study aimed to compare the effectiveness, compliance, and safety between 3-L split-dose and 2-L PEG in Chinese population. Consecutive patients scheduled for colonoscopy were recruited from 5 tertiary medical centers in South China between April and July, 2014. Patients were prospectively randomized into 2 groups: 3-L split-dose PEG (3L-group) and 2 L PEG (2L-group). The primary endpoint was bowel cleansing and was defined according to Ottawa Bowel Preparation Scale (OBPS). The safety and compliance were also evaluated. A total of 318 patients were included in the analysis. The mean total OBPS score was significantly higher in 2L-group than in 3L-group (4.4 ± 2.7 vs 2.9 ± 2.4, P < 0.001). Both the intention-to-treat and per-protocol analysis found that rates of successful and excellent bowel preparation were much higher in 3L-group (89.9% and 78.0%) than 2L-group (79.2% and 48.4%), respectively (P < 0.001). The average cecum intubation time was significantly shorter in 3L-group (8.2 ± 3.7 min) than in 2L-group (10.3 ± 4.2 min) (P = 0.04). Adenoma detection rate in right colon was slightly higher in 3L-group than in 2L-group (17.6% vs 12.6%, P = 0.21). The safety and compliance including the taste, smell, and dosage of PEG were similar between 2 groups (P > 0.05). 3-L split-dose PEG is superior to 2-L PEG by better bowel cleansing, improved safety and compliance, shorter cecum intubation time, and potentially higher adenoma detection rate in rightward colon in Chinese population.
authors: From the Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University (SZ, ML, YC, MC); Division of Gastroenterology, Guangzhou Military General Hospital, Guangzhou (YZ); Division of Gastroenterology, The University of Hong Kong-Shenzhen Hospital (TL); Division of Gastroenterology, The First Affiliated Hospital of Shenzhen University, Shenzhen (QS); Division of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China (FZ).
authors: Shenghong
authors: S
authors: Zhang
authors: Minrui
authors: M
authors: Li
authors: Yagang
authors: Y
authors: Zhao
authors: Tao
authors: T
authors: Lv
authors: Qing
authors: Q
authors: Shu
authors: Fachao
authors: F
authors: Zhi
authors: Yi
authors: Y
authors: Cui
authors: Minhu
authors: M
authors: Chen
mesh_terms: D000236:Adenoma / Q000175:diagnosis; D000328:Adult; D044466:Asian People; D049628:Body Size; D002400:Cathartics / Q000008:administration & dosage*; D002681:China; D003110:Colonic Neoplasms / Q000175:diagnosis; D003113:Colonoscopy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D016037:Single-Blind Method
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols
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