Sa1458 Nicevis: results of a randomised controlled trial of simeticone and n-acetylcysteine as a pre-procedure drink to Improve mucosal visibility during diagnostic gastroscopy

Basford, Peter, Brown, James Francis, Gadeke, Lisa, Fogg, Carole Lesley, Haysom-Newport, Ben, Ogollah, Reuben, Higgins, Bernard Robert, Bhattacharyya, Rupam, Longcroft-Wheaton, Gaius, Thursby-Pelham, Fergus, Neale, Jo and Bhandari, Pradeep (2015) Sa1458 Nicevis: results of a randomised controlled trial of simeticone and n-acetylcysteine as a pre-procedure drink to Improve mucosal visibility during diagnostic gastroscopy. Gastrointestinal Endoscopy, 81 (5 Supplement), ab224. (doi:10.1016/j.gie.2015.03.1295).

Abstract

Introduction: Despite advances in endoscope technology there is still a significant miss rate of neoplastic lesions during gastroscopy. Mucosal views are frequently impaired by residual bubbles and mucus.Method: We conducted an RCT in 126 patients attending for routine gastroscopy. Subjects were randomised in a 1:1:1ratio to receive a pre-procedure drink of water, simeticone and n-acetylcysteine (Group A), water alone (Group B) or nopreparation (Group C). Study endoscopists were blinded to group allocation. 4 digital images were taken at pre-defined locations during the procedure – lower oesophagus, upper body, antrum & fundus. Images were rated for mucosalvisibility (MV) using a 4 point scale (1 = best, 4 = worst) by 4 blinded experienced endoscopists. Primary outcome measure was mean MV score. Secondary outcome measures were procedure duration and volume of flush required to achieve adequate mucosal views.Results: Groups were well matched for age, gender or indication for endoscopy. Mean MV score for group A was significantly better than for group B and group C (p <0.001 for both comparisons), with no significant difference between groups B and C (p=0.541). Interobserver agreement of MV scores was good (mean kappa 0.464).Mean volume of flush required to achieve adequate mucosal views was significantly lower in group A than group B(p=0.001), and group C (P

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Contributors

Author: Carole Lesley Fogg

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