The efficacy and safety of disposable endoscopes in reducing persistent microbial contamination: a systematic review and meta-analysis comparing technical performance with reusable endoscopes.

BACKGROUND

Endoscopy is essential for diagnosis and treatment, but reusable endoscopes pose contamination risks despite strict cleaning. Disposable endoscopes may reduce this risk.

AIM: To evaluate the effectiveness of disposable endoscopes in minimizing microbial contamination compared to reusable endoscopes.

METHODS

In this systematic review and meta-analysis, PubMed, Web of Science, and Scopus were searched up to March 1st, 2024, for cohort, case-control, and randomized controlled trials comparing reusable and disposable endoscopes in terms of performance and contamination. Data were analysed using mean difference (MD) and risk ratio (RR) with 95% confidence interval (CI). Publication bias was assessed using the Luis Furuya-Kanamori (LFK) index, and heterogeneity was evaluated with I2 and Cochran's Q test.

FINDINGS: This meta-analysis included 15 studies; disposable endoscopes were used by 2571 participants, reusable ones by 5607. The latter was found to have a 25% higher complication risk (RR: 1.25; 95% CI: 1.08-1.44). The fever incidence was much lower in the disposable group (RR: 0.38; 95% CI: 0.20-0.72). No meaningful differences were found in the hospital stay (MD: -0.14; 95% CI: -0.39 to 0.11). Significant differences were not shown by positive urine cultures (RR: 1.93; 95% CI: 0.03-123.15) or urosepsis rates (RR: 0.45; 95% CI: 0.16-1.27).

CONCLUSION

Disposable endoscopes have notably reduced fever risk in comparison to reusable ones. However, urosepsis rates, positive urine cultures, and hospital stay showed no differences. Consideration of cost and environmental impact is recommended.