Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 5/2017

01-05-2017

Phosphate tablets or polyethylene glycol for preparation to colonoscopy? A multicentre non-inferiority randomized controlled trial

Authors: Stanislas Chaussade, Christoph Schmöcker, Pierre Toulemonde, Miguel Muñoz-Navas, Valérie O’Mahony, Franck Henri

Published in: Surgical Endoscopy | Issue 5/2017

Login to get access

Abstract

Background

Adequate bowel preparation is a crucial step in colonoscopy procedure and has been identified as the cornerstone of a quality colonoscopy. Polyethylene glycol (PEG) for bowel cleansing still had up to 10 % unprepared colon.

Aim

We herein compare efficacy, acceptability, tolerance and safety of sodium phosphate (NaP) tablets and split-dose PEG for bowel cleansing.

Patients and methods

A prospective non-inferiority randomized trial was performed and registered on www.​clinicaltrials.​gov (NCT01840553). Patients were randomized to either 32 NaP tablets or 4 L of PEG. Blind readers assessed the efficacy of colon cleansing using the Boston Bowel Preparation Scale (BBPS).

Results

A total of 461 patients were randomized in groups (NaP group: n = 231; PEG group: n = 230). Median age was 54 and 52 in NaP group and PEG group, respectively (p < 0.01). Patients experienced an overall compliance to the treatment in 99.6 and 94.1 % in the NaP group and in the PEG group, respectively (p < 0.001). The mean time of withdrawal was 15.1 ± 8.9 and 15.4 ± 9.5 min in the NaP group and in the PEG group, respectively (p = 0.95). The good quality of bowel preparation, defined as BBPS score ≥7, was obtained in 86.4 and 89.0 % of cases in the NaP group and in the PEG group, respectively (p = 0.42). In all segment (right colon, transverse colon and left colon and rectum), the NaP group was non-inferior to the PEG group. Bowel prep regimen was more frequently considered as “easy” by patients from the NaP group (54.8 % of patients) than patients from the PEG group (29.0 % of patients; p < 0.001). No serious adverse events were reported. No statistical differences were found between the NaP group and the PEG group concerning the incidence of an adverse event (338 vs. 322, respectively).

Conclusion

While NaP tablets appeared as efficient as PEG in terms of colon cleansing prior to a colonoscopy, they significantly improved the overall compliance and eased product administration. At an era where bowel cleansing appears to be the cornerstone of a quality colonoscopy, NaP tablets in patients without contraindication might be considered as an option.
Appendix
Available only for authorised users
Literature
1.
Coriat R, Lecler A, Lamarque D, Deyra J, Roche H, Nizou C et al (2012) Quality indicators for colonoscopy procedures: a prospective multicentre method for endoscopy units. PLoS One 7(4):e33957CrossRefPubMedPubMedCentral
2.
Coriat R, Pommaret E, Chryssostalis A, Viennot S, Gaudric M, Brezault C et al (2009) Quality control of colonoscopy procedures: a prospective validated method for the evaluation of professional practices applicable to all endoscopic units. Gastroenterol Clin Biol 33(2):103–108CrossRefPubMed
3.
Parente F, Marino B, Crosta C (2009) Bowel preparation before colonoscopy in the era of mass screening for colo-rectal cancer: a practical approach. Dig Liver Dis 41(2):87–95CrossRefPubMed
4.
DiPalma JA, Brady CE 3rd, Stewart DL, Karlin DA, McKinney MK, Clement DJ et al (1984) Comparison of colon cleansing methods in preparation for colonoscopy. Gastroenterology 86(5 Pt 1):856–860PubMed
5.
Wexner SD, Beck DE, Baron TH, Fanelli RD, Hyman N, Shen B et al (2006) A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Gastrointest Endosc 63(7):894–909CrossRefPubMed
6.
Coriat R, Polin V, Oudjit A, Henri F, Dhooge M, Leblanc S et al (2014) Gastric emptying evaluation by ultrasound prior colonoscopy: an easy tool following bowel preparation. World J Gastroenterol 20(37):13591–13598CrossRefPubMedPubMedCentral
7.
Lai EJ, Calderwood AH, Doros G, Fix OK, Jacobson BC (2009) The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research. Gastrointest Endosc 69(3 Pt 2):620–625CrossRefPubMedPubMedCentral
8.
Johanson JF, Popp JW Jr, Cohen LB, Lottes SR, Forbes WP, Walker K et al (2007) A randomized, multicenter study comparing the safety and efficacy of sodium phosphate tablets with 2 L polyethylene glycol solution plus bisacodyl tablets for colon cleansing. Am J Gastroenterol 102(10):2238–2246CrossRefPubMed
9.
Rex DK, Schwartz H, Goldstein M, Popp J, Katz S, Barish C et al (2006) Safety and colon-cleansing efficacy of a new residue-free formulation of sodium phosphate tablets. Am J Gastroenterol 101(11):2594–2604CrossRefPubMed
10.
Hagège H, Laugier R, Nahon S, Coulom P, Isnard-Bagnis C, Albert-Marty A (2015) Real-life conditions of use of sodium phosphate tablets for colon cleansing before colonoscopy. Endosc Int Open 3(4):E346–E353CrossRefPubMedPubMedCentral
11.
Rex DK (2006) Maximizing detection of adenomas and cancers during colonoscopy. Am J Gastroenterol 101(12):2866–2877CrossRefPubMed
12.
Coriat R, Lecler A, Cassaz C, Roche H, Podevin P, Mesnard B et al (2009) Évaluation des pratiques professionnelles en endoscopie: étude multicentrique de faisabilité d’une méthode simple et reproductible d’évaluation de la qualité de la coloscopie dans des structures privées et publiques. Gastroenterol Clin Biol 33(HS1):175CrossRef
13.
de Jonge V, Sint Nicolaas J, Cahen DL, Moolenaar W, Ouwendijk RJ, Tang TJ et al (2011) Quality evaluation of colonoscopy reporting and colonoscopy performance in daily clinical practice. Gastrointest Endosc 75(1):98–106CrossRefPubMed
14.
Lee YH, Jeong SY, Kim YS, Jung HJ, Kwon MJ, Kwak CH et al (2015) Randomized controlled trial of sodium phosphate tablets versus 2 L polyethylene glycol solution for bowel cleansing prior colonoscopy. Korean J Gastroenterol 65(1):27–34CrossRefPubMed
Metadata
Title
Phosphate tablets or polyethylene glycol for preparation to colonoscopy? A multicentre non-inferiority randomized controlled trial
Authors
Stanislas Chaussade
Christoph Schmöcker
Pierre Toulemonde
Miguel Muñoz-Navas
Valérie O’Mahony
Franck Henri
Publication date
01-05-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 5/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5214-1

Other articles of this Issue 5/2017

Surgical Endoscopy 5/2017 Go to the issue

OriginalPaper

Simulation-based camera navigation training in laparoscopy—a randomized trial

OriginalPaper

Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution

OriginalPaper

Effects and results of fibrin sealant use in 1000 laparoscopic sleeve gastrectomy cases

OriginalPaper

A systematic examination of preoperative surgery warm-up routines

EAES Research Agenda

A research agenda for the European Association for Endoscopic Surgeons (EAES)

OriginalPaper

LABEL procedure: Laser-Assisted Bile duct Exploration by Laparoendoscopy for choledocholithiasis: improving surgical outcomes and reducing technical failure