Abstrakt
Michal Stepan1,5,6, Petr Fojtík1,5, Robert Psar3,7, Martin Hanousek1, Marek Sabol1, Jana Zapletalova4, Premysl Falt2
1Digestive Diseases Center, Vítkovice Hospital, Ostrava, Czech Republic
22nd Department of Internal Medicine, University Hospital and Faculty of Medicine, Palacky University, Olomouc, Czech Republic
3Department of Radiology, Vítkovice Hospital, Ostrava, Czech Republic
4Institute of Medical Biophysics, Faculty of Medicine, Palacky University, Olomouc, Czech Republic
5Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
6Faculty of Medicine, Palacky University, Olomouc, Czech Republic
7Department of Radiology, University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University Olomouc, Czech Republic
Objective
The aim of the study was to demonstrate that an administration of mucolytic solution with a maximum dose of simethicone and N-acetylcystein before upper endoscopy improves mucosal visibility compared to a group without administration of mucolytic solution or water.
Methods
This study was a double-blind, randomized controlled trial. Patients were randomized into four groups, with the administration of 100 ml of water + 600 mg N-acetylcysteine + 400 mg simethicone, 100 ml of water + 400 mg N-acetylcysteine + 20 mg simethicone, 100 ml of water, and without any water or mucolytic solution. During the examination, a total of 10 images were taken in the defined areas. The overall visibility score was given by the sum of the 0-5 scores of the five areas and was assessed by the endoscopist performing the procedure and the by blinded endoscopists using static images.
Results
A total of 129 patients were randomized. Group of patients did not differ in age, gender distribution and indications significantly. The overall visibility score as assessed by the endoscopist performing the procedure was significantly higher in the group with the maximum dose of mucolytic solution compared to the group without solution or water (18.9±2.9 vs. 16.6±3.3, p=0.023). This difference was not evident by blinded evaluation of static photographs.
Conclusion
Administration of mucolytic solution with a maximum dose of N-acetylcysteine and simethicone before upper endoscopy improved mucosal visibility in the upper gastrointestinal tract compared with the group without any preparation while evaluated by performing endoscopist.
Keywords
Visibility score, upper endoscopy, N-acetylcysteine, simethicon, mucolytic solution
