Efectividad de la premedicación con N-acetil cisteína más dimetilpolisiloxano versus un placebo para mejorar la visibilidad en la endoscopia digestiva: estudio prospectivo, ciego, controlado aleatorizado

Medicina

Oscar Fernando Ruíz-Morales¹  William Otero-Regino²  Martín Alonso Gómez-Zuleta² 

[1] Hospital Nacional Universitario y Hospital de Kennedy;Universidad Nacional de Colombia;

关键词: endoscopia digestiva alta;    dimetilpolisiloxano;    N-acetilcisteína;    cáncer de estómago;    tamizaje;    Upper digestive tract endoscopy;    dimethypolisyloxane;    N-acetyl-cysteine;    gastric cancer;    screening;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction: Gastric cancer is the most prevalent malignant tumor in Colombia, its treatment is essential to detect it at an early stage. Unfortunately in Colombia, more than 90 % of the cases are diagnosed in an advanced stage; unlike in Japan where less than 50 % are advanced, this is because screening upper digestive-tract endoscopies (UDTE) are done and because all are premedicated with a solution that cleans mucus and saliva. The main objective of this paper is to evaluate if the preparation with a solution before UDTE improves gastric visibility. Design: This is a prospective, double-blind, randomized, and controlled study conducted between January and June 2016. Material and methods: Outpatients receiving UDTE were randomized into two groups. Group A was given 100 ml of water mixed with 400 mg of N-acetyl cysteine (NAC) and 200 mg (3 cm3, 66 mg / cm3 solution) of DMPS half an hour before the test. For those in Group B, only 100 ml of water were administered half an hour earlier. All the solutions were prepared in capped bottles so that their contents were seen neither by the patient nor the doctor. After endoscopy, preparation was evaluated on a previously validated visual scale and the results were compared between the two groups. Results: In total we included 203 patients with a mean age of 57 years, of which 62.2 % were women. In group A we included 98 patients and 105 in group B. There were no differences in age or sex in either group. When assessing the visibility of the mucosa we found that the total visibility index or IVT was 4.8 ± 2.2 in group A versus 7.4 ± 2.9 in group B with a p<0.00. As for the endoscopic findings, we found that in 3 patients in group A, an early cancer was diagnosed vs none in group B; in 8 patients of Group A, polyps were found vs 4 in group B; in 71.4 % of the cases the physician suggested a pangastritis in Group A versus 53.2 % of group B. Conclusions: A preparation with a 100 ml solution of water containing NAC plus DMPS half an hour before endoscopy is feasible and significantly improves the visibility of the stomach mucosa, which makes possible to detect more cases of structural lesions

【 授权许可】

Unknown