Effect of Different Moisturizing Agents on Cleaning Quality of Rigid Endoscopes: A Meta-Analysis

ObjectiveThis study aims to evaluate the effects on the cleaning quality of rigid endoscopes of four moisturizing agents, including multi-enzyme cleaner, self-made heparin, foam multi-enzyme moisturizer, and gel moisturizer.MethodsA systematic search of Chinese and English databases covering CNKI, WanFang, VIP, CBM, PubMed, Web of Science, and Embase was conducted for randomized controlled trials (RCTs) evaluating moisturizing agents for cleaning rigid endoscopes from database inception to March 2025. Meta-analysis was performed using the software RevMan 5.3.ResultsA total of nine randomized controlled trials were included in the meta-analysis. Compared with multi-enzyme cleaner, self-made heparin significantly improved the cleaning pass rate of rigid endoscopes as assessed by visual inspection (RR=1.01, 95% CI: 1.00~1.03; P=0.03) and residual protein test (RR=1.01, 95% CI: 1.00~1.03; P=0.04). Foam multi-enzyme moisturizer demonstrated superior cleaning efficacy to multi-enzyme cleaner in ATP bioluminescence assay (RR=1.23, 95% CI: 1.03~1.48; P=0.02) and occult blood test (RR=1.10, 95% CI: 1.04~1.17; P=0.002). However, no statistically significant difference was observed between the two agents in visual inspection (RR=1.04, 95% CI: 0.99~1.09; P=0.14) or residual protein test (RR=1.08, 95% CI: 0.93~1.26; P=0.31). Gel moisturizer significantly outperformed multi-enzyme cleaner in both visual inspection (RR=1.05, 95% CI: 1.03~1.08; P=0.001) and occult blood test (RR=1.02, 95% CI: 1.00~1.05; P=0.02).ConclusionSelf-made heparin and gel moisturizer demonstrated superior cleaning efficacy compared with the multi-enzyme cleaner for rigid endoscopes. Foam multi-enzyme moisturizer significantly outperformed multi-enzyme cleaner in ATP bioluminescence and occult blood tests but showed no significant advantage in visual inspection or residual protein testing. These findings support the selective application of alternative moisturizing agents based on cleaning assessment methods and clinical context.