Effects of L-Menthol and Carbon Dioxide on the Adenoma Detection Rate during Colonoscopy: L-Menthol and Carbon Dioxide on Colonoscopy.
Digestion
; 101(3): 323-331, 2020.
Article
em En
| MEDLINE
| ID: mdl-30844795
ABSTRACT
BACKGROUND AND AIMS:
We examined the efficacy of the combined use of L-menthol spraying (L-mentholS) as an antispasmodic agent and carbon dioxide insufflation (CO2I) on the adenoma detection rate (ADR) in a prospective, single-center trial with a 2 × 2 factorial design.METHODS:
We randomly assigned 611 patients scheduled to undergo colonoscopy to 4 groups (1) the L-mentholS + CO2I (n = 153), (2) L-mentholS + air insufflation (AI; n = 156), (3) CO2I (n = 153), and (4) AI (n = 149) groups. We used 20 mL of 0.8%-L-menthol solution for the L-mentholS. The primary outcome was the difference in the ADR, and the secondary outcomes were the differences in colonic peristalsis and abdominal pain. -Results:
The ADRs were not different among the groups 1/2/3/4; 39.9%/43.6%/41.2%/51.0%. CO2I was associated with a significant decrease in the ADR (OR 0.57; 95% CI 0.35- 0.93) with a multiple logistic regression. The interaction between L-mentholS and CO2I was associated with a suppression of the decrease in the ADR. Both L-mentholS and CO2I were associated with a significant decrease in abdominal pain, and L-mentholS was associated with a significant improvement of peristalsis.CONCLUSIONS:
The fact that CO2I was associated with significant decreases in the ADR was a problem. The combined use of L-mentholS and CO2I could help to suppress the decrease in the ADR.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Parassimpatolíticos
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Insuflação
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Neoplasias Colorretais
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Adenoma
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Colonoscopia
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Detecção Precoce de Câncer
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article