Clinical Endoscopy

Original Articles

Novel regimen for colonoscopy bowel preparation with oral lactulose: a prospective comparative study: Josué Aliaga Ramos, Danilo Carvalho, Vitor N. Arantes; Clin Endosc 2024;57(6):775-782. Published online October 22, 2024; DOI: https://doi.org/10.5946/ce.2024.056

Background
/Aims: Polyethylene glycol (PEG) is considered the gold standard regimen for bowel preparation; however, due to the necessity of a large volume, patient tolerance is impaired. Therefore, lactulose is a novel alternative for colonoscopy preparation. This study aimed to investigate the efficacy and safety of lactulose-based bowel preparations in comparison with PEG for colonoscopy.
Methods
This is a prospective, non-blinded, comparative study. Outpatients were randomly divided into two groups: group 1 (111 patients), PEG; and group 2 (111 patients), lactulose. The following clinical outcomes were assessed in each group: degree of bowel clearance using the Boston bowel preparation score, colorectal polyp detection rate, adenoma detection rate, tolerability, and side effects.
Results
The rate of inadequate bowel preparation was 8.1% and 1.8% for the PEG and lactulose groups, respectively (p=0.030). The Boston bowel preparation score for the entire colon was 7.34±1.17 and 8.36±1.09 for the PEG and lactulose groups, respectively (p<0.001). The satisfactory overall experience rates were 27.9% and 62.2% for the PEG and lactulose groups, respectively (p<0.001).
Conclusions
The novel bowel preparation with oral lactulose was superior to that with PEG in terms of colon cleansing, adenoma detection rate, tolerance, and patient experience.

Citations

Citations to this article as recorded by

ERAS-based sequential olive oil-lactulose protocol in day-case laparoscopic inguinal hernia repair: a prospective comparison
Xiaoqin Zhou, Penghui Liu, Gengyu Tong Zhao, Deyan Bai, Wenqing Liu, Yueqian Zeng, Run Wan, Huijia Pan, Jie Mao
Frontiers in Surgery.2026;[Epub] CrossRef
Innovative schemes of colonoscopy bowel preparation with oral lactulose: Optimizing traditional standards to improve colonoscopy quality
Josué Aliaga Ramos, Danilo Carvalho, Vitor Nunes Arantes
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Bowel Preparation Agents: Balancing Efficacy for Colon Cleansing and Safety for Stomach Safety
Gwang Ha Kim
The Korean Journal of Gastroenterology.2024; 84(6): 293. CrossRef

18,845 View
513 Download
3 Web of Science
3 Crossref

Management of esophageal neoplasms by endoscopic submucosal dissection: experience over 100 consecutive procedures: Josué Aliaga Ramos, Yoshinori Morita, Takashi Toyonaga, Danilo Carvalho, Moises Salgado Pedrosa, Vitor N. Arantes; Clin Endosc 2023;56(5):613-622. Published online May 17, 2023; DOI: https://doi.org/10.5946/ce.2022.245

Graphical Abstract Abstract PDF

Background
/Aims: Endoscopic submucosal dissection (ESD) is currently considered the first-line treatment for the eradication of superficial neoplasms of the esophagus in Eastern countries. However, in the West, particularly in Latin America, the experience with esophageal ESD is still limited because of the high technical complexity required for its execution. This study aimed to present the results of the clinical application of ESD to manage superficial esophageal neoplasms in a Latin American center in over 100 consecutive cases.
Methods
This retrospective study included consecutive patients who underwent endoscopic ESD for superficial esophageal neoplasms between 2009 and 2022. The following clinical outcomes were assessed: en bloc, complete, and curative resection rates, local recurrence, adverse events, and procedure-related mortality.
Results
Esophageal ESD was performed mainly for squamous cell carcinoma (66.6%), high-grade intraepithelial neoplasia (17.1%), and adenocarcinoma (11.4%). En bloc and complete resection rates were 96.2% and 81.0%, respectively. The curative resection rate was 64.8%. Adverse events occurred in six cases (5.7%). Endoscopic follow-up was performed for an average period of 29.7 months.
Conclusions
ESD performed by trained operators is feasible, safe, and clinically effective for managing superficial neoplastic lesions of the esophagus in Latin America.

Citations

Citations to this article as recorded by

Endoscopic treatment of esophageal high-grade intraepithelial neoplasia
Caifa Hong, Yawen Zheng
Asian Journal of Surgery.2026;[Epub] CrossRef

6,639 View
108 Download
1 Crossref

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