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Does Premedication with Mucolytic Agents Improve Mucosal Visualization during Oesophagogastroduodenoscopy: A
Eoghan Burke1, Patricia Harkins2, Frank Moriarty3
1Our Lady of Lourdes Hospital, Drogheda, Co Louth, Ireland.
Surgery Research and Practice
|February 8, 2021
Summary
Premedication with mucolytic agents significantly improves gastric mucosal visibility during oesophagogastroduodenoscopy (OGD) for early gastric cancer detection. This safe and effective strategy enhances diagnostic accuracy without reported adverse events.
Area of Science:
- Gastroenterology
- Oncology
- Medical Diagnostics
Background:
- Gastric cancer (GC) is a leading cause of cancer mortality globally.
- Oesophagogastroduodenoscopy (OGD) is the standard for GC diagnosis.
- Gastric mucus impedes early GC detection during OGD.
Purpose of the Study:
- To evaluate the efficacy of mucolytic agents as premedication for improving mucosal visibility during OGD.
- To compare mucolytic agents against placebo or other mucolytics in adults undergoing elective OGD.
Main Methods:
- Systematic review and random-effects meta-analysis of 13 studies (11,086 patients).
- Searched PubMed, EMBASE, CINAHL, CENTRAL, and Web of Science.
- Analyzed total mucosal visibility scores (TMVS) and subgroup analyses for simethicone, dosage, and timing.
Main Results:
- Pooled mucolytic agents showed a significant improvement in TMVS (mean difference -2.69).
- Simethicone demonstrated effectiveness (mean difference -2.68), with 133mg being optimal (mean difference -4.22).
- Premedication >20 minutes prior improved TMVS (mean difference -3.68); no adverse events were reported.
Conclusions:
- Routine premedication with mucolytic agents enhances TMVS during OGD.
- This intervention improves diagnostic potential for early gastric cancer.
- The use of mucolytic agents is safe, with no adverse events noted.
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