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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(11): E1658-E1673
DOI: 10.1055/a-1529-5814
Review

Efficacy of bowel preparation regimens for colon capsule endoscopy: a systematic review and meta-analysis

Thomas Bjoersum-Meyer
 1   Department of Surgery, Odense University Hospital, Odense Denmark
,
Karolina Skonieczna-Zydecka
 2   Department of Biochemical Sciences, Pomeranian Medical University, Szczecin, Poland
,
Pablo Cortegoso Valdivia
 3   Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Parma, Italy.
,
Irene Stenfors
 4   Department of Gastroenterology, Skåne University Hospital, Malmö, Lund University, Sweden
,
Ivan Lyutakov
 5   Department of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Medical University Sofia, Bulgaria
,
Emanuele Rondonotti
 6   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
Marco Pennazio
 7   University Division of Gastroenterology, City of Health and Science University Hospital, Turin, Italy
,
Wojciech Marlicz
 8   Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
 9   The Centre for Digestive Diseases, Endoklinika, Szczecin, Poland
,
Gunnar Baatrup
 1   Department of Surgery, Odense University Hospital, Odense Denmark
,
Anastasios Koulaouzidis
10   Department of Social Medicine & Public Health, Pomeranian Medical University, Szczecin, Poland
,
Ervin Toth
 4   Department of Gastroenterology, Skåne University Hospital, Malmö, Lund University, Sweden
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Abstract

Background and study aims Colon capsule endoscopy (CCE) is an alternative to conventional colonoscopy (CC) in specific clinical settings. High completion rates (CRs) and adequate cleanliness rates (ACRs) are fundamental quality parameters if CCE is to be widely implemented as a CC equivalent diagnostic modality. We conducted a systematic review and meta-analysis to investigate the efficacy of different bowel preparations regimens on CR and ACR in CCE.

Patients and methods We performed a systematic literature search in PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library. Data were independently extracted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The primary outcome measures (CR, ACR) were retrieved from the individual studies and pooled event rates were calculated.

Results Thirty-four observational (OBS) studies (n = 3,789) and 12 randomized clinical trials (RCTs) (n = 1,214) comprising a total 5,003 patients were included. The overall CR was 0.798 (95 % CI, 0.764–0.828); the highest CRs were observed with sodium phosphate (NaP) + gastrografin booster (n = 2, CR = 0.931, 95 % CI, 0.820–0.976). The overall ACR was 0.768 (95 % CI, 0.735–0.797); the highest ACRs were observed with polyethylene glycol (PEG) + magnesium citrate (n = 4, ER = 0.953, 95 % CI, 0.896–0.979).

Conclusions In the largest meta-analysis on CCE bowel preparation regimens, we found that both CRs and ACRs are suboptimal compared to the minimum recommended standards for CC. PEG laxative and NaP booster were the most commonly used but were not associated with higher CRs or ACRs. Well-designed studies on CCE should be performed to find the optimal preparation regimen.

Supplementary material



Publication History

Received: 25 February 2021

Accepted: 04 June 2021

Article published online:
12 November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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