Optimizing colonoscopy with abdominal compression devices: an updated meta-analysis of randomized controlled trials

Colonoscopy is a vital procedure for colorectal cancer screening and intervention; however, it can be uncomfortable for patients, particularly older people and those with diverticular disease. In our systematic review and meta-analysis, we aimed to evaluate the impact of abdominal compression devices (ACDs) on patient comfort and procedural efficiency during colonoscopy.

A literature search was performed in PubMed, Web of Science, Scopus, Cochrane Central, and Embase from inception to April 2025. A risk of bias assessment was performed by using the Cochrane tool for assessing risk of bias in randomized trials, version 2 (ROB2). Data analysis was conducted using R version 4.2.2 and RStudio version 2022.07.2.

Our comprehensive search across multiple databases yielded 16 randomized controlled trials involving 3098 participants. Our analysis revealed that ACDs significantly reduced cecal intubation time (mean difference: -2.20, 95% confidence interval [CI]: -3.50 to -0.90; P = 0.009), manual pressure application (risk ratio [RR]: 0.54, 95% CI: 0.39 to 0.76; P = 0.003), and the need for patient repositioning (RR: 0.55, 95% CI: 0.48 to 0.64; P > 0.001). Additionally, ACDs were associated with lower visual analog scale pain scores, indicating enhanced patient satisfaction. However, no significant differences in complete colonoscopy rates or cecal intubation lengths were found.

Our findings suggest that ACDs can optimize colonoscopy procedures, improve patient comfort, and reduce staff workload, warranting their integration into routine practice. Future studies should focus on standardizing ACD applications and exploring long-term outcomes to further enhance the benefits of this approach in clinical settings.