TOPLINE

A compression device worn around the abdomen during colonoscopy reduced cecal intubation time by more than 1.5 minutes and significantly lowered post-procedural pain, the need for manual abdominal pressure, and patient position changes. Greatest improvements were seen in patients who were lean or had obesity.

METHODOLOGY

• A systematic review and meta-analysis of 14 randomized controlled trials involving 2834 adults undergoing elective diagnostic or screening colonoscopy was conducted.
• Participants in the included trials were randomly assigned to receive an abdominal binder (elastic corset, compression belt, or pneumatic device) or standard care without compression during colonoscopy.
• Primary outcomes included cecal intubation time, post-procedural pain, need for manual abdominal pressure, and need for patient position change.
• BMI was analyzed as a pre-specified effect modifier using tertile-based strata: lean (BMI, < 26), intermediate (BMI, 26-28), and obese (BMI, > 28).

TAKEAWAY

• Application of an abdominal binder was associated with a significant reduction in cecal intubation time (pooled mean difference [MD], −1.576 min; P < .001; I² = 94.98%; n = 14 trials).
• Post-procedural pain was significantly lower with binder use (pooled standardized MD, −0.853; P < .001; I² = 93.54%; n = 8 trials).
• The need for manual abdominal pressure was reduced by nearly half (risk ratio [RR], 0.522; P < .001; I² = 78.84%; n = 11 trials), as was the need for a change in patient position (RR, 0.569; P < .001; I² = 15.77%; n = 11 trials).
• BMI-stratified analysis revealed a non-monotonic response: lean and obese strata showed significant benefit for cecal intubation time and manual pressure, while the intermediate stratum did not reach significance.

IN PRACTICE

"The clinical findings of this analysis should be interpreted as exploratory and hypothesis-generating," wrote the authors of the study.

SOURCE

The study was led by Yu-Kuang Kang, Department of Internal Medicine, Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan. It was published online on July 20 in Therapeutic Advances in Gastroenterology.

LIMITATIONS

BMI stratification was performed at the study level rather than the individual-patient level. The intermediate BMI subgroup for post-procedural pain was contributed by a single trial. Technical heterogeneity across trials included variation in binder type, application timing, sedation regimen, and endoscopist experience. Most trials were open-label or single-blind, and performance bias on subjective outcomes cannot be fully excluded.

DISCLOSURES

The study received no specific funding. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.