Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023, 167(1):69-73 | DOI: 10.5507/bp.2021.038

Michal Stepan1, 2, Premysl Falt2, Barbora Pipek1, 2, 4, Petr Fojtik1, 4, Martin Hanousek1, Martin Hill3, Ondrej Urban2 1 Digestive Diseases Center, Vtkovice Hospital, Ostrava, Czech Republic 2 Department of Internal Medicine II - Gastroenterology and Hepatology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic 3 Institute of Endocrinology, Prague, Czech Republic 4 Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic

Aims: Sufficient visibility of the mucosa during upper endoscopy is crucial for successful diagnosis, especially for early neoplastic lesions. Data documenting the effect of administration of mucolytic solution prior to gastroscopy in order to improve mucosal visibility are limited in Europe. The aim of the study was to assess the score of mucosal visibility in the upper gastrointestinal tract after administration of the mucolytic solution defined by us.

Patients and Methods: This is a monocentric, double-blind, randomized study involving 134 patients indicated for diagnostic upper endoscopy. Patients were randomly assigned to one of three arms, with mucolytic solution (100 mL water + 400 mg N-acetylcysteine + 20 mg simethicone), without the solution , and with 100 mL pure water. During the examination, 11 photographs were taken in defined areas. The visibility score was given by the sum of the score 0-5 from 5 defined localities evaluated by a blinded endoscopist and subsequently by two blinded endoscopists. Other parameters monitored were examination time and a semiquantitative evaluation of residual gastric fluid.

Results: The basic characteristics of the group (sex, age, indications for examination) were comparable between arms. The visibility score was similar in all arms - 17.4 ± 1.9 vs. 17.0 ± 2.0 vs. 17.6 ± 1.8 (P=0.32). The examination time and the amount of residual fluid in the stomach were comparable in all arms.

Conclusions: Administration of the mucolytic solution in our study did not increase the mucosal visibility score in the esophagus, stomach and duodenum. Trial Registration: ClinicalTrials.gov, NCT02967094.

Keywords: upper endoscopy, visibility score, mucolytic solution, N-acetylcysteine, simethicon

Stepan, M., Falt, P., Pipek, B., Fojtik, P., Hanousek, M., Hill, M., & Urban, O. (2023). Administration of mucolytic solution before upper endoscopy - double-blind, monocentric, randomized study. Biomedical Papers,167(1),69-73. doi:10.5507/bp.2021.038

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