Title: 3 L split-dose polyethylene glycol is superior to 2 L polyethylene glycol in colonoscopic
bowel preparation in relatively high-BMI (# 24 kg/m2) individuals:A multicenter randomized
controlled trial
Version: 1 Date: 01 Oct 2023
Reviewer's report:
Review of the manuscript d0bc2882-6522-4daa-a2ba-d645dc9b41b5
3 L split-dose polyethylene glycol is superior to 2 L polyethylene glycol in colonoscopic bowel
preparation in relatively high-BMI individuals: A multicenter randomized controlled trial.
By Hailin Yan, et al.
This large multicenter single-blinded randomized controlled trial tried to clear the effectiveness
of 3 L split-dose PEG for adequate bowel cleansing during colonoscopy preparation. 3 L split-
dose PEG improves preparation scale than 2 L dose PEG in high-BMI individuals, especially
in those with a high BMI of 25-29.9 kg/m2.
Though this large-sample trial has been competently conducted and is interesting, it has several
problems as indicated below.
General comments
INTRODUCTION:
While it is still controversial whether obesity affects preparation for colonoscopy as the authors
wrote in their manuscript, there is a lack of explanation as to why they intended to evaluate
3 L split-dose PEG for the preparation. Many methods to enhance the preparation (add other
laxatives, use special meals for the colonoscopy, use 4 L PEG, etc.) are available, but why 3 L
split-dose PEG was so important?
RESULTS:
Insufficient information on patient characteristics. Additional information is also required
regarding the history of abdominal surgery other than intestinal resection (gynecological
surgery, nephrectomy) and daily use of laxatives. Endoscopic findings such as diverticulosis,
tumors, or stenosis that may affect preparation should be noted as well.
DISCUSSION:
As the authors indicated, 81.2% of the rate of adequacy is not enough, and thus would it be
better to use a 4L regimen or change the oral preparation than a 3L regimen? The authors should
mention this issue and discuss it. Moreover, it seems the success rate of adequate preparation
did not depend on BMI in the 2L group.
Lack of clear conclusion. Please state your conclusion clearly. What did you ultimately want
to insist on with this paper?
Specific comment
I could not understand the meaning of the sentence in P.12 L.12 “study on the by…”
Title: 3 L split-dose polyethylene glycol is superior to 2 L polyethylene glycol in colonoscopic
bowel preparation in relatively high-BMI (# 24 kg/m2) individuals:A multicenter randomized
controlled trial
Version: 1 Date: 01 Oct 2023
Reviewer's report:
Review of the manuscript d0bc2882-6522-4daa-a2ba-d645dc9b41b5
3 L split-dose polyethylene glycol is superior to 2 L polyethylene glycol in colonoscopic bowel
preparation in relatively high-BMI individuals: A multicenter randomized controlled trial.
By Hailin Yan, et al.
This large multicenter single-blinded randomized controlled trial tried to clear the effectiveness
of 3 L split-dose PEG for adequate bowel cleansing during colonoscopy preparation. 3 L split-
dose PEG improves preparation scale than 2 L dose PEG in high-BMI individuals, especially
in those with a high BMI of 25-29.9 kg/m2.
Though this large-sample trial has been competently conducted and is interesting, it has several
problems as indicated below.
General comments
INTRODUCTION:
While it is still controversial whether obesity affects preparation for colonoscopy as the authors
wrote in their manuscript, there is a lack of explanation as to why they intended to evaluate
3 L split-dose PEG for the preparation. Many methods to enhance the preparation (add other
laxatives, use special meals for the colonoscopy, use 4 L PEG, etc.) are available, but why 3 L
split-dose PEG was so important?
RESULTS:
Insufficient information on patient characteristics. Additional information is also required
regarding the history of abdominal surgery other than intestinal resection (gynecological
surgery, nephrectomy) and daily use of laxatives. Endoscopic findings such as diverticulosis,
tumors, or stenosis that may affect preparation should be noted as well.
DISCUSSION:
As the authors indicated, 81.2% of the rate of adequacy is not enough, and thus would it be
better to use a 4L regimen or change the oral preparation than a 3L regimen? The authors should
mention this issue and discuss it. Moreover, it seems the success rate of adequate preparation
did not depend on BMI in the 2L group.
Lack of clear conclusion. Please state your conclusion clearly. What did you ultimately want
to insist on with this paper?
Specific comment
I could not understand the meaning of the sentence in P.12 L.12 “study on the by…”
Please review this paper.
user
Title: 3 L split-dose polyethylene glycol is superior to 2 L polyethylene glycol in colonoscopic
bowel preparation in relatively high-BMI (# 24 kg/m2) individuals:A multicenter randomized
controlled trial
Version: 1 Date: 01 Oct 2023
Reviewer's report:
Review of the manuscript d0bc2882-6522-4daa-a2ba-d645dc9b41b5
3 L split-dose polyethylene glycol is superior to 2 L polyethylene glycol in colonoscopic bowel
preparation in relatively high-BMI individuals: A multicenter randomized controlled trial.
By Hailin Yan, et al.
This large multicenter single-blinded randomized controlled trial tried to clear the effectiveness
of 3 L split-dose PEG for adequate bowel cleansing during colonoscopy preparation. 3 L split-
dose PEG improves preparation scale than 2 L dose PEG in high-BMI individuals, especially
in those with a high BMI of 25-29.9 kg/m2.
Though this large-sample trial has been competently conducted and is interesting, it has several
problems as indicated below.
General comments
INTRODUCTION:
While it is still controversial whether obesity affects preparation for colonoscopy as the authors
wrote in their manuscript, there is a lack of explanation as to why they intended to evaluate
3 L split-dose PEG for the preparation. Many methods to enhance the preparation (add other
laxatives, use special meals for the colonoscopy, use 4 L PEG, etc.) are available, but why 3 L
split-dose PEG was so important?
RESULTS:
Insufficient information on patient characteristics. Additional information is also required
regarding the history of abdominal surgery other than intestinal resection (gynecological
surgery, nephrectomy) and daily use of laxatives. Endoscopic findings such as diverticulosis,
tumors, or stenosis that may affect preparation should be noted as well.
DISCUSSION:
As the authors indicated, 81.2% of the rate of adequacy is not enough, and thus would it be
better to use a 4L regimen or change the oral preparation than a 3L regimen? The authors should
mention this issue and discuss it. Moreover, it seems the success rate of adequate preparation
did not depend on BMI in the 2L group.
Lack of clear conclusion. Please state your conclusion clearly. What did you ultimately want
to insist on with this paper?
Specific comment
I could not understand the meaning of the sentence in P.12 L.12 “study on the by…”
assistant