水交换结肠镜检查与空气充气结肠镜检查对腺瘤检出率影响的Meta分析

Meta Analysis of the Adenoma Detection Rate of Water Exchange Colonoscopy and Air Inflation Colonoscopy

目的:比较水交换结肠镜检查(WE)和传统空气充气结肠镜检查(AI)对结肠镜腺瘤检出率的影响。方法:通过PubMed、Embase、Web of Science,搜索截止2023年10月发表的文章,使用Review Manager 5.3和Stata 11.0进行分析,比较水交换结肠镜和传统空气充气结肠镜在检查过程中的腺瘤检出率、达盲率、达盲时间、退镜时间的差异。结果:10项研究共7024受检者符合纳入标准。WE组的腺瘤检出率高于AI组,差异有统计学意义(RR = 1.41, 95% CI: 1.26~1.57, P < 0.00001)。在达盲率方面,WE组和AI组比较,差异无统计学意(RR = 1.00, 95% CI: 0.99~1.01, P = 0.77)。WE组所需达盲时间大于AI组,差异有统计学意义(MD = 2.70, 95% CI: 0.44~4.96, P = 0.02)。WE组所需退镜时间大于AI组,差异有统计学意义(MD = 0.54, 95% CI: 0.10~0.99, P = 0.02)。Egger检验未见明显发表偏倚。结论:水交换结肠镜相较于空气充气结肠镜,可以提高腺瘤检出率,整体检查成功率相近,但检查效率略微逊色。

Objective: To compare the water exchange colonoscopy with the air insufflation colonoscopy, to de-termine the impact of adenoma detection rate. Methods: Search for articles up to October 2023 through PubMed, Embase, and Web of Science. Use Review Manager 5.3 and Stata 11.0 for analysis to compare water exchange colonoscopy and the air insufflation colonoscopy. The differences in ad-enoma detection rate, blind rate, blind time and withdrawal time were compared. Results: Ten studies with a total of 7024 participants met the inclusion criteria. Meta-analysis showed that the water exchange group had higher adenoma detection rate (RR = 1.41, 95% CI: 1.26~1.57, P < 0.00001). There was no significant difference in cecal intubation rate (RR = 1.00, 95% CI: 0.99~1.01, P = 0.77). The water exchange group had longer cecal intubation time (MD = 2.70, 95% CI: 0.44~4.96, P = 0.02) and withdrawal time (MD = 0.54, 95% CI: 0.10~0.99, P = 0.02) than the air in-sufflation group. There was no obvious publication bias after Egger test. Conclusion: WE compared to AI can increase ADR, and the overall inspection success rate is similar, but the inspection effi-ciency is slightly inferior.