EfÏcacy of improved premedication for gastroscopy

Abstract

Background: Mongolians have the highest incidence of stomach cancer’s death rate in the world. In our country, 80% of stomach gastric cancers are diagnosed in the late stage, so the mortality rate is high. One of the reasons for late diagnosis is the quality of endoscopic examination of the upper gastrointestinal tract. An important factor is the need to quality of preparation for endoscopic procedure. Inadequate preparation of the upper gastrointestinal endoscopy leads to a reduction in the detection of newly diagnosed mucosal diseases, early gastric cancer and precancerous lesions. In our country, there is a lack of comparative research on the quality and effectiveness of cleaning methods used in upper endoscopy, and the lack of standardized criteria and instruction of gastric cleansing methods and guidelines. Aim: We aimed to evaluate the clearance of gastric mucus and bubble using improved premedication for gastroscopy Materials and Methods: This was a randomized, double-blinded, clinical trial study. There were 1 control group: Simethicone (S) 200 mg; experimental group I: S 200 mg+N-acetylcysteine (NAC) 200 mg+NaHCO3 2 g; and experimental group II: S 200 mg+NAC 600 mg+NaHCO3 2 g. The 108 clients were randomly selected who admitted upper endoscopic examination at Department of endoscopy of Mongolia-Japan hospital. The solution was ingested 20 minutes before upper endoscopy. Gastric visibility was evaluated by score in 4 parts. T-test and chi-square test approach was done for statistical analysis. Results: The clearance of gastric bubble and mucus after using three kinds (control, experimental group I and experimental group II) of premedication was evaluated by endoscopy. In the control group: the 36.1% (n=13) of total cases were well cleaned, 47.2% (n=17) were moderately cleaned and 16.7% (n=6) were poorly cleaned. In the experimental group I: 47% (n=17) of total cases were cleaned well, 36.1% (n=13) were moderate and 16.1% (n=6) were poorly cleared.(p<0.186) In Experiment Group II: 86.1% (n=31) were well cleaned, 13.8% (n=5) were moderately cleaned whereas none cases were reported poorly cleaned. (p<0.001) Conclusion: The appearance of gastric mucus and bubble clearance was best in experimental II group which is our improved premedication recipe for gastroscopy. It could improve the quality of upper gastrointestinal tract endoscopy and met with international research results.