Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
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DOI：
10.1055/s-0032-1326186
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发表时间：
2013-02-01
期刊：
影响因子：
9.3
通讯作者：
Dumonceau, J. M.
中科院分区：
文献类型：
--
作者：
Hassan, C.;Bretthauer, M.;Dumonceau, J. M.
背景和目的：本指南是欧洲胃肠内镜学会（ESGE）的官方声明。它解决了方案之间的选择，可用于清洗结肠准备colonoscopic.Methods：本指南是基于有针对性的文献检索，以评估支持使用肠道准备结肠镜检查的证据。采用GRADE（Grading of Recommendations Assessment，Development and Evaluation）评分系统对推荐强度和证据质量进行评价。(1)ESGE建议在结肠镜检查前一天进行低纤维饮食（弱推荐，中等质量证据）。(2)ESGE建议采用4 L聚乙二醇（PEG）溶液的分次方案（或在下午结肠镜检查的情况下采用当天方案）进行常规肠道准备。2L PEG+抗坏血酸或匹可硫酸钠+柠檬酸镁的分次方案（或下午结肠镜检查的当天方案）可能是有效的替代方案，特别是对于择期门诊结肠镜检查（强烈推荐，高质量证据）。在肾衰竭患者中，PEG是唯一推荐的肠道准备。最后一次肠道准备和结肠镜检查之间的延迟应尽量减少，不超过4小时（强烈建议，中等质量证据）。(3)由于安全性问题，ESGE建议不要常规使用磷酸钠进行肠道准备（强烈建议，低质量证据）。
Background and aim: This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the choice amongst regimens available for cleansing the colon in preparation for colonoscopy.Methods: This Guideline is based on a targeted literature search to evaluate the evidence supporting the use of bowel preparation for colonoscopy. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendation and the quality of evidence.Results: The main recommendations are as follows. (1) The ESGE recommends a low-fiber diet on the day preceding colonoscopy (weak recommendation, moderate quality evidence). (2) The ESGE recommends a split regimen of 4L of polyethylene glycol (PEG) solution (or a same-day regimen in the case of afternoon colonoscopy) for routine bowel preparation. A split regimen (or same-day regimen in the case of afternoon colonoscopy) of 2L PEG plus ascorbate or of sodium picosulphate plus magnesium citratemay be valid alternatives, in particular for elective outpatient colonoscopy (strong recommendation, high quality evidence). In patients with renal failure, PEG is the only recommended bowel preparation. The delay between the last dose of bowel preparation and colonoscopy should be minimized and no longer than 4 hours (strong recommendation, moderate quality evidence). (3) The ESGE advises against the routine use of sodium phosphate for bowel preparation because of safety concerns (strong recommendation, low quality evidence).