{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:33:43Z","timestamp":1790249623057,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,3,27]],"date-time":"2012-03-27T00:00:00Z","timestamp":1332806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Carbon dioxide (<jats:styled-content style=\"fixed-case\"><jats:roman>CO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content>) insufflation has been proposed as an alternative to air insufflation to distend the lumen in gastrointestinal (<jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content>) endoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To perform a systematic review with meta\u2010analysis of randomised controlled trials (<jats:styled-content style=\"fixed-case\">RCTs<\/jats:styled-content>) in which <jats:styled-content style=\"fixed-case\"><jats:roman>CO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> insufflation was compared with room air insufflation in <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> endoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic and manual searches were combined to search <jats:styled-content style=\"fixed-case\">RCTs<\/jats:styled-content>. After methodological quality assessment and data extraction, the efficacy and safety of <jats:styled-content style=\"fixed-case\"><jats:roman>CO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> insufflation were systematically assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010one <jats:styled-content style=\"fixed-case\">RCTs<\/jats:styled-content> [13 on colonoscopy, four on endoscopic retrograde cholangiopancreatography (<jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content>), two on double\u2010balloon enteroscopy (<jats:styled-content style=\"fixed-case\">DBE<\/jats:styled-content>), one on oesophagogastroduodenoscopy, and one on flexible sigmoidoscopy] were identified. For colonoscopy, <jats:styled-content style=\"fixed-case\"><jats:roman>CO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> insufflation resulted lower postprocedural pain intensity, and increased the proportion of patient without pain at 1\u00a0h (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 1.84, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.37\u20132.47) and 6\u00a0h (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 1.28; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.14\u20131.44) postprocedure. For <jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content>, the pain\u2010releasing effect of <jats:styled-content style=\"fixed-case\"><jats:roman>CO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> insufflation was not obvious (<jats:styled-content style=\"fixed-case\">SMD<\/jats:styled-content>: \u22121.48, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: \u22123.56, 0.59). <jats:styled-content style=\"fixed-case\"><jats:roman>CO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> insufflation revealed no consistent advantages in the <jats:styled-content style=\"fixed-case\">RCTs<\/jats:styled-content> of <jats:styled-content style=\"fixed-case\">DBE<\/jats:styled-content>, but was shown as safe as air insufflation in oesophagus\/stomach endoscopic submucosal dissection in one study. <jats:styled-content style=\"fixed-case\"><jats:roman>pCO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> level showed no significant variation during these procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with air insufflation, <jats:styled-content style=\"fixed-case\"><jats:roman>CO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> insufflation during colonoscopy causes lower postprocedural pain and bowel distension without significant <jats:styled-content style=\"fixed-case\"><jats:roman>pCO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> variation. More <jats:styled-content style=\"fixed-case\">RCTs<\/jats:styled-content> are needed to assess its advantages in other GI endoscopic procedures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2036.2012.05078.x","type":"journal-article","created":{"date-parts":[[2012,3,27]],"date-time":"2012-03-27T15:00:27Z","timestamp":1332860427000},"page":"1145-1154","source":"Crossref","is-referenced-by-count":69,"title":["Meta\u2010analysis: the use of carbon dioxide insufflation vs. room air insufflation for gastrointestinal endoscopy"],"prefix":"10.1111","volume":"35","author":[{"given":"W. L.","family":"Wang","sequence":"first","affiliation":[{"name":"Key Laboratory of Combined Multi\u2010organ Transplantation Ministry of Public Health Hangzhou China"},{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of Surgery the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z. H.","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Combined Multi\u2010organ Transplantation Ministry of Public Health Hangzhou China"},{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of Surgery the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Sun","sequence":"additional","affiliation":[{"name":"Key Laboratory of Combined Multi\u2010organ Transplantation Ministry of Public Health Hangzhou China"},{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of Surgery the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. F.","family":"Wei","sequence":"additional","affiliation":[{"name":"Key Laboratory of Combined Multi\u2010organ Transplantation Ministry of Public Health Hangzhou China"},{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of Surgery the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X. F.","family":"Chen","sequence":"additional","affiliation":[{"name":"Key Laboratory of Combined Multi\u2010organ Transplantation Ministry of Public Health Hangzhou China"},{"name":"Division of Hepatobiliary and Pancreatic Surgery Department of Surgery the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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