Single versus split dose polyethylene glycol for bowel preparation in children undergoing colonoscopy: a systematic review and meta-analysis

Background: Polyethylene glycol (PEG) has been widely used for bowel preparation. However, the efficacy and safety of single and split dose PEG for bowel preparation in children undergoing colonoscopy remain unclear, it is necessary to evaluate the role of single and split dose PEG for bowel preparation in children population. Methods: PubMed et al. databases up to September 1, 2019 were systematically searched. Randomized controlled trials (RCTs) single and split dose PEG for bowel preparation in children undergoing colonoscopy were included. Based on the heterogeneity, data were synthesized using random-effects or fixed-effects models. Results were expressed as Mantel-Haenszel style odds ratio (OR) or mean difference (MD) with 95% confidence interval (95% CI). Results: Four RCTs with 249 children were included. There was no significantly difference in the efficacy of single and split dose PEG for bowel preparation (OR=0.36, 95% CI: -0.12 to 1.10). The acceptability of split dose PEG for bowel preparation was significantly higher than that of single dose (OR=0.50, 95% CI: 0.29 to 0.85); the incidence of nausea in split dose PEG for bowel preparation was significantly lower than that of single dose (OR=2.1, 95% CI: 1.29 to 3.42); there was no significant difference on the incidence of abdominal pain between two regimes (OR=1.39, 95% CI: 0.67 to 2.89). Conclusions: Split dose PEG seems to be more superior to single dose for children undergoing colonoscopy. However, considering that the number of included RCTs are very limited, more related studies on this issue are needed in the future.