Benefit of pronase in image quality during EUS

Han, Jae Pil; Hong, Su Jin; Moon, Jong Ho; Lee, Gun Hwa; Byun, Jin; Kim, Hwa Jong; Ko, Bong Min; Lee, Moon Sung

doi:10.1016/j.gie.2011.07.044

Cited by 9 publications

(10 citation statements)

References 15 publications

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“…Therefore, both the drugs can improve the mucosal visibility of UGI endoscopy [6, 10, 11]. Previous studies on UGI endoscopy premedication have focused on mucosal visibility [4, 7, 9, 12–15], and a recently published double-blind randomized trial has proved that both pronase and simethicone can result in better visibility [16].…”

Section: Discussionmentioning

confidence: 99%

Effect of premedication on lesion detection rate and visualization of the mucosa during upper gastrointestinal endoscopy: a multicenter large sample randomized controlled double-blind study

et al. 2018

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BackgroundPremedication in upper gastrointestinal endoscopy for higher lesions detection rate has not been well studied so far. This study aimed to confirm whether premedication could improve the detection rate of early cancer or precancerous lesions and mucosal visibility.MethodFrom July 2015 to December 2015, 7200 participants from 6 centers were screened by endoscopy with one of the 4 following premedications randomly: (1) water (group D); (2) pronase (group A); (3) simethicone (group B); (4) pronase and simethicone (group C). Early cancer and precancerous lesions detection rates were taken as the primary endpoints, and mucosal visibility was taken as the secondary endpoint. They were compared among four groups to determine different premedication effects in terms of different anatomical sites. Trial was registered at Chinese Clinical Trial Registry; the registration number is ChiCTR-IOR-17010985.ResultsThe upper gastrointestinal overall precancerous lesion detection rates among four groups were 8.7, 8.4, 10.0, and 10.3%, the overall early cancer detection rates were 1.3, 1.4%, 1.5, and 1.6%, both without significant difference (p = 0.138 and 0.878). However, the visibility score distributions between control group (D) and premedication groups (A, B, and C) were all statistically significant, with all anatomical sites p values < 0.001. Subgroup analyses, from 2 centers without screening before, also showed significant difference in esophageal (3.9, 3.3, 4.5, and 8.4% with p = 0.004) and overall (7.0, 5.5, 7.3, and 12.0% with p = 0.004) precancerous lesion detection rate.ConclusionsPremedication with pronase and simethicone may not increase lesion detection rates but could significantly increase the upper gastrointestinal mucosal visibility.

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Section: Discussionmentioning

confidence: 99%

Effect of premedication on lesion detection rate and visualization of the mucosa during upper gastrointestinal endoscopy: a multicenter large sample randomized controlled double-blind study

et al. 2018

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“…In 2003, Sakai et al[15] reported the first Pronase trial and suggested that premedication with Pronase reduced artifacts during endoscopic ultrasonography. In 2011, Han et al[24] found that premedication with bicarbonate mixed with Pronase decreased the number of hyperechoic artifacts secondary to the stomach wall and lumen during EUS.…”

Section: Discussionmentioning

confidence: 99%

“…The eligibility and exclusion criteria are listed in Table 1. At least 102 patients were needed to acquire 90% statistical power based on a previous study performed by Han et al[24] in 2011. All patients provided written informed consent before the procedure.…”

Section: Methodsmentioning

confidence: 99%

“…As previously reported[15,24], for EUS imaging, the gastric cavity obscurity grade is scored from 0 to 3 (Figure 1), according to the number of high-echo spots, as shown in Table 2. EUS imaging of the gastric wall surface was similarly scored (Figure 2), as shown in Table 3.…”

Section: Methodsmentioning

confidence: 99%

“…Sakai et al[15] found that pretreatment with Pronase could reduce artifacts during an EUS examination. Han et al[24] also found that premedication with a mixture containing bicarbonate and Pronase seemed to reduce hyperechoic artifacts secondary to the gastric wall and lumen.…”

Section: Introductionmentioning

confidence: 99%

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Effects of premedication with Pronase for endoscopic ultrasound of the stomach: A randomized controlled trial

Wang

Xiang

Wang

et al. 2016

WJG

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AIMTo analyze the effects of premedication with Pronase for endoscopic ultrasound (EUS) examination of the stomach.METHODSThis was a prospective, randomized and controlled clinical study. All patients were randomly assigned to either the Pronase group or placebo group. The pretreatment solution was a mixed solution of 20000 U of Pronase and 60 mL sodium bicarbonate solution in the Pronase group, while an equal amount of sodium bicarbonate solution was administered to the placebo group. All operators, image evaluators and experimental recorders in EUS did not participate in the preparation and allocation of pretreatment solution. Two blinded investigators assessed the obscurity scores for the EUS images according to the size of artifacts (including ultrasound images of the gastric cavity and the gastric wall). Differences in imaging quality, the duration of examination and the usage of physiological saline during the examination process between the Pronase group and the control group were compared.RESULTSNo differences existed in patient demographics between the two groups. For the gastric cavity, the Pronase group had significantly lower mean obscurity scores than the placebo group (1.0476 ± 0.77 vs 1.6129 ± 0.96, respectively, P = 0.000). The mean obscurity scores for the gastric mucosal surface were significantly lower in the Pronase group than the placebo group (1.2063 ± 0.90 vs 1.7581 ± 0.84, respectively, P = 0.001). The average EUS procedure duration for the Pronase group was 11.60 ± 3.32 min, which was significantly shorter than that of the placebo group (13.13 ± 3.81 min, P = 0.007). Less saline was used in the Pronase group than the placebo group, and the difference was significant (417.94 ± 121.38 mL vs 467.42 ± 104.52 mL, respectively, P = 0.016).CONCLUSIONThe group that had Pronase premedication prior to the EUS examination had clearer images than the placebo group. With Pronase premedication, the examination time was shorter, and the amount of saline used during the EUS examination was less.

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Application of a novel kind of endoscopic sterile ultrasonic couplant using in miniprobe endoscopic ultrasonography

Ma,

Li,

Jiang

2024

EngMedicine

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Benefit of pronase in image quality during EUS

Cited by 9 publications

References 15 publications

Effect of premedication on lesion detection rate and visualization of the mucosa during upper gastrointestinal endoscopy: a multicenter large sample randomized controlled double-blind study

Effect of premedication on lesion detection rate and visualization of the mucosa during upper gastrointestinal endoscopy: a multicenter large sample randomized controlled double-blind study

Effects of premedication with Pronase for endoscopic ultrasound of the stomach: A randomized controlled trial

Application of a novel kind of endoscopic sterile ultrasonic couplant using in miniprobe endoscopic ultrasonography

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