Prospective comparison of different admission time of polyethylene glycol-electrolyte lavage solution regimens for bowel preparation in pediatric colonoscopy / 中华消化内镜杂志

ABSTRACT

Objective To evaluate effects of different admission time of polyethylene glycol-electrolyte lavage solution ( PEG-ELS) regimens on bowel preparation before colonoscopy in children and to seek better regimens. Methods Children ( 3-18 years old ) receiving colonoscopy under sedation in Shanghai Children's Medical Center from July 2016 to July 2017 were prospectively enrolled in the controlgroup ( n=64) and intervention group ( n=97) , according to convenience sampling. Children in the control group on the two-day regimen took PEG-ELS at 7 pm for 2 consecutive nights before colonoscopy, and those in the intervention group took PEG-ELS at 7 pm the day before colonoscopy and 430 am on the day of colonoscopy. All children had the same low-fiber diet for 3 days before colonoscopy. Main outcome measures were intestinal clearance and enema rate. Secondary outcome measures were medication compliance, acceptance and tolerance. The Chi-square test was used to analyze the relevant indicators between the two groups. Results There were no significant differences in gender composition, mean age, indication composition and medication adherence between the two groups ( P>0. 05) . The intestinal clearance rate was significantly higher in the intervention group than that in the control group [ 93. 8％ ( 91/97 ) VS 42. 2％(27/64)] with significant difference (χ2=52. 502, P=0. 000). The enema rate was significantly lower in the intervention group[ 17. 5％ ( 17/97) VS 96. 9％ ( 62/64) ] with significant difference (χ2=97. 145, P=0. 000). In terms of medication acceptance, the acceptance rate of the intervention group was higher[51. 5％( 50/97) VS 39. 1％ ( 25/64 ) ] with no significant difference (χ2 = 0. 215, P= 0. 643 ) . In terms of medication tolerance, the asymptomatic rate of the intervention group was higher than that of the control group [ 36. 1％ ( 35/97) VS 14. 1％ ( 9/64) ] , and the difference was statistically significant (χ2=14. 062, P= 0. 007 ) . The incidence of nausea was lower in the intervention group [ 1. 0％ ( 1/97 ) VS 6. 3％(4/64)], with no significant difference (χ2=3. 490, P=0. 082).The incidence of vomiting was higher in the intervention group [29. 9％ (29/97) VS 29. 7％ (19/64)] with no significant difference (χ2=0. 001, P=1. 000).The incidence of abdominal pain was lower in the intervention group [25. 8％ (25/97) VS 43. 8％ (28/64)] with significant difference (χ2=5. 643, P=0. 025).The incidence of anal discomfort was higher in the intervention group [7. 2％ (7/97) VS 6. 3 ％(4/64)], with no significant difference (χ2=0. 057, P=1. 000) . Conclusion The one-day split-dosage PEG-ELS regimen has better efficacy and safety in bowel preparations, and it can effectively reduce the incidence of abdominal pain.