Meta-Analysis
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World J Gastroenterol. Jun 14, 2014; 20(22): 7034-7039
Published online Jun 14, 2014. doi: 10.3748/wjg.v20.i22.7034
Does hyoscine butylbromide really improve polyp detection during colonoscopy? A meta-analysis of randomized controlled trials
Pei-Jing Cui, Jing Yao, Hua-Zhong Han, Yi-Jun Zhao, Jun Yang
Pei-Jing Cui, Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Jing Yao, Hua-Zhong Han, Yi-Jun Zhao, Jun Yang, Department of Surgery, Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
Author contributions: Cui PJ and Yao J contributed equally to this work; Yang J designed the research; Cui PJ, Yao J and Zhao YJ performed the data search and meta-analysis; Han HZ and Yang J wrote the paper.
Correspondence to: Jun Yang, MD, PhD, Department of Surgery, Sixth People’s Hospital, Shanghai Jiao Tong University, Xuhui District, No. 600 Yishan Road, Shanghai 200233, China. yangjuns@foxmail.com
Telephone: +86-21-64369181 Fax: +86-21-64368920
Received: November 12, 2013
Revised: January 12, 2014
Accepted: February 20, 2014
Published online: June 14, 2014
Abstract

AIM: To investigate the benefits of hyoscine butylbromide in polyp detection during colonoscopy by a meta-analysis of available randomized controlled trials (RCTs).

METHODS: Databases, including PubMed, EMBASE, the Cochrane Library, and the Science Citation Index up to September 2013, were searched. The primary outcome was polyp detection rate, and the secondary outcome was adenoma detection rate. The meta-analysis was performed using the free software Review Manager. Differences observed between the treated and the control groups were expressed as odds ratio (OR) with a 95% confidence interval (CI). A fixed-effects model was used to pool data when statistical heterogeneity was absent. If statistical heterogeneity was present (P < 0.05), a random-effects model was used.

RESULTS: The initial search identified nine articles. After screening, five RCTs with a total of 1998 patients were included in this meta-analysis. Of the five studies, all described a comparison of baseline patient characteristics and showed that there was no statistically significant difference between the two groups. Among the 1998 patients, 1006 received hyoscine butylbromide and 992 were allocated to the control group, and the polyp detection rate was reported. There were no significant differences between the treated and the control group (OR = 1.09, 95%CI: 0.91-1.31, P = 0.33). Four RCTs included 1882 patients, of whom 948 received hyoscine butylbromide, and the adenoma detection rate was reported. There were no significant differences between the treated and the control group (OR = 1.13, 95%CI: 0.92-1.38, P = 0.24).

CONCLUSION: The use of hyoscine butylbromide did not significantly improve the polyp detection rate during colonoscopy.

Keywords: Hyoscine butylbromide, Polyp detection, Adenoma detection, Colonoscopy

Core tip: There is a debate as to whether hyoscine butylbromide can really improve polyp detection during colonoscopy. We performed a meta-analysis of the results of randomized controlled trials to investigate the benefits of hyoscine butylbromide in polyp detection during colonoscopy. We found that the use of hyoscine butylbromide did not significantly improve the polyp detection rate during colonoscopy.