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• W2912941651 abstract "Introduction: Colonoscopy is the gold standard test for prevention of colorectal adenocarcinoma by identifying and removal of adenomas, the pre-cancerous lesion. One of the most common complications from colonoscopy is postprocedural abdominal pain and discomfort due to air insufflation during the procedure. Carbon dioxide(CO2) insufflation has been shown to reduce post procedure crampy abdomen pain due to easy dissolvability in blood and rapid elimination. However the effect of CO2 insufflation on adenoma detection rate(ADR) remained unclear, with studies showing positive and negative effect on ADR. We aimed to do a meta-analysis to identify the effect of CO2 insufflation on ADR when compared to air insufflation by pooling results of individual studies. Methods: Comprehensive literature search was performed in EMBASE, Scopus, Pubmed, Cochrane databases from 1946 to May 31, 2017 to identify potential articles. MeSH headings included in the search included adenoma detection rate, colonoscopy, carbon dioxide insuffl ation. All references from the identified articles were further searched to find more articles. Abstracts published from major gastroenterology meetings were also searched up to May 2017. Studies were included if they compared ADR on cohorts of patients undergoing colonoscopy with CO2 insufflation and air insufflation and had no major differences in baseline characteristics. Odds ratio of ADR was compared between the 2 techniques. Statistics were done using Revman version 5.3 Results: A total of 202 articles were identified from the search strategy and from articles identified through references and abstracts. A total of 4 studies met the inclusion criteria and out of which 3 were published manuscripts and one was abstract. Total number of patients included in the analysis was 3466(2140 in CO2 group, 1326 in air insufflation group). There was no statistically significant difference in ADR between the 2 groups - 1.11 [0.95-1.31](Image 1). However there was significant heterogeneity between the tests, possibly due to low number of studies that qualified for inclusion. Conclusion: CO2 insufflation appears to be non-inferior for adenoma detection when compared to air insufflation. With no disadvantage on ADR with using CO2 insufflation, endoscopy units should adapt the change from air to CO2 insufflation to improve patient experience. Future large randomized trial should be done to study if CO2 insufflation improves ADR when comparing air insufflation.Figure" @default.
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• W2912941651 date "2017-10-01" @default.
• W2912941651 modified "2023-10-12" @default.
• W2912941651 title "Effect of Carbon Dioxide Insufflation on Adenoma Detection Rate in Comparison to Air Insufflation: A Meta-Analysis" @default.
• W2912941651 doi "https://doi.org/10.14309/00000434-201710001-00220" @default.
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