Clin Endosc.  2023 Jul;56(4):446-452. 10.5946/ce.2022.304.

Use of abdominal compression device in colonoscopy: a systematic review and meta-analysis

• Zafar Y
• Rashid AM
• Javaid SS
• Siddiqi AK
• Zafar A
• Iqbal AZ
• Klair JS
• Krishnamoorthi R

• KMID: 2544565
• DOI: http://doi.org/10.5946/ce.2022.304

Abstract

Background/Aims
Colonoscopy for screening is associated with unpleasant experiences for patients, and abdominal compression devices have been developed to minimize these problems. However, there is a paucity of data supporting the therapeutic benefits of this strategy. This study examined the effects of using an abdominal compression device during colonoscopy on the cecal intubation time (CIT), abdominal compression, patient comfort, and postural changes.
Methods
We searched PubMed and Scopus (from inception to November 2021) for randomized controlled trials that assessed the effects of an abdominal compression device during colonoscopy on CIT, abdominal compression, patient comfort, and postural change. A random-effects meta-analysis was performed. Weighted mean differences (WMDs) and Mantel-Haenszel odds ratios (ORs) were calculated.
Results
Our pooled analysis of seven randomized controlled trials revealed that abdominal compression devices significantly reduced CIT (WMD, –0.76 [–1.49 to –0.03] minutes; p=0.04), abdominal compression (OR, 0.52; 95% confidence interval [CI], 0.28–0.94; p=0.03), and postural changes (OR, 0.46; 95% CI, 0.27–0.78; p=0.004) during colonoscopy. However, our results did not show a significant change in patient comfort (WMD, –0.48; 95% CI, –1.05 to 0.08; p=0.09) when using an abdominal compression device.
Conclusions
Our findings demonstrate that employing an abdominal compression device may reduce CIT, abdominal compression, and postural change but have no impact on patient comfort.

Keyword

Abdominal compression device; Cecal intubation; Colonoscopy; Patient comfort; Visceral pain

Figure

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  Fig. 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart.

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  Fig. 2. Forest plot of (A) abdominal compression, (B) patient comfort, and (C) postural change. M-H, Mantel–Haenszel; CI, confidence interval; SD, standard deviation.

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  Fig. 3. Forest plot of cecal intubation time. SD, standard deviation; IV, intravenous; CI, confidence interval.

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  Fig. 4. Different types of abdominal compression devices available for use during colonoscopy.

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