Abstract
Background and Aim: The efficacy of encircling abdominal compression devices in colonoscopies is inconsistent. We performed a meta-analysis of randomized controlled trials (RCTs) in which encircling abdominal compression devices were compared with control in colonoscopies. Methods: We systematically searched RCTs published in the Cochrane Library, PubMed, and the Igaku-Chuo-Zasshi database. The data from the eligible RCTs were combined using the random-effects model. The weighted mean differences (WMDs), pooled odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. Results: Five RCTs were included in this meta-analysis. Compared to the control group, encircling abdominal compression devices significantly reduced the caecal intubation time (WMD: −1.31, 95% CI: −2.40 to −0.23, p = 0.02). Compared to the control group, encircling abdominal compression devices significantly decreased the frequency of postural change (OR 0.30, 95% CI: 0.22 to 0.41, p < 0.00001). Compared to the control group, the use of encircling abdominal compression devices significantly reduced the need for abdominal compression (OR: 0.35, 95% CI: 0.17 to 0.70, p = 0.003). Conclusions: Encircling abdominal compression devices in colonoscopies was found to reduce the caecal intubation time and the frequency of abdominal compression.
Highlights
IntroductionColonoscopy is essential for colorectal cancer screening as well as therapeutic procedures [1,2,3,4]
Colonoscopy is essential for colorectal cancer screening as well as therapeutic procedures [1,2,3,4].Despite the advancements in colonoscopy equipment and progress in the endoscopists’ skills, colonoscopy can be difficult and painful for some patients
Compared to the control group, encircling abdominal compression devices did not significantly reduce the patient-reported comfort level (WMD: −0.58, 95% confidence intervals (CIs): −1.27 to 0.11, p = 0.10)
Summary
Colonoscopy is essential for colorectal cancer screening as well as therapeutic procedures [1,2,3,4]. Despite the advancements in colonoscopy equipment and progress in the endoscopists’ skills, colonoscopy can be difficult and painful for some patients. The formation of a sigmoid loop causes severe pain and makes endoscope insertion difficult. Ancillary maneuvres such as position change and abdominal pressure are often added. Position change needs at least one or more assistants, when the patients are under sedation. Abdominal pressure depends on the assistants’ skill, and sometimes does not exert effective pressure when inappropriately applied. The efficacy of encircling abdominal compression devices in colonoscopies is inconsistent. We performed a meta-analysis of randomized controlled trials (RCTs) in which encircling abdominal compression devices were compared with control in colonoscopies
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