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Ouazana S, Baltes P, Toth E, Lüttge H, Nemeth A, Beaumont H, González-Suárez B, Lee PS, Carretero C, Margalit Yehuda R, Elli L, Spada C, Bruno M, Mussetto A, Cortegoso Valdivia P, Becq A, Corbett G, Martin A, Robertson A, Benamouzig R, Despott E, Riccioni ME, Sidhu R, Calavas L, Ellul P, Finta A, Triantafyllou K, Rondonotti E, Kirchgesner J, Elosua A, McNamara D, Dray X. Endoscopic GI placement of capsule endoscopy to investigate the small bowel: a multicenter European retrospective series of 630 procedures in adult patients. Gastrointest Endosc 2024; 100:492-500. [PMID: 38272273 DOI: 10.1016/j.gie.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/29/2023] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND AND AIMS Small-bowel (SB) capsule endoscopy (CE) is a first-line procedure for exploring the SB. Endoscopic GI PlacemenT (EGIPT) of SB CE is sometimes necessary. Although experience with EGIPT is considerable in pediatric populations, we aimed to describe the safety, efficacy, and outcomes of EGIPT of SB CE in adult patients. METHODS The international CApsule endoscopy REsearch (iCARE) group set up a retrospective multicenter study. Patients over age 18 years who underwent EGIPT of SB CE before May 2022 were included. Data were collected from medical records and capsule recordings. The primary endpoint was the technical success rate of the EGIPT procedures. RESULTS Of 39,565 patients from 29 centers, 630 (1.6%) were included (mean age, 62.5 years; 55.9% women). The technical success of EGIPT was achieved in 610 procedures (96.8%). Anesthesia (moderate to deep sedation or general anesthesia) and centers with intermediate or high procedure loads were independent factors of technical success. Severe adverse events occurred in 3 patients (.5%). When technically successful, EGIPT was associated with a high SB CE completion rate (84.4%) and with a substantial diagnostic yield (61.1%). The completion rate was significantly higher when the capsule was delivered in the SB compared with when it was delivered in the stomach. CONCLUSIONS EGIPT of SB CE is highly feasible and safe, with a high completion rate and diagnostic yield. When indicated, it should be performed with patients under anesthesia, and the capsule should be delivered in the duodenum rather than the stomach for better SB examination outcomes.
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Affiliation(s)
- Salome Ouazana
- Center for digestive endoscopy, Sorbonne University, Saint Antoine Hospital, APHP Paris, Paris, France
| | - Peter Baltes
- Clinic for Internal Medicine, Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany
| | - Ervin Toth
- Department of Gastroenterology, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Hannah Lüttge
- Clinic for Internal Medicine, Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany
| | - Artur Nemeth
- Department of Gastroenterology, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Hanneke Beaumont
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Begoña González-Suárez
- Endoscopy Unit, Gastroenterology Department, ICMiD, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Phey Shen Lee
- Department of Gastroenterology, South Tyneside and Sunderland NHS Foundation Trust, South Shields, NE34 0PL, UK
| | - Cristina Carretero
- Department of Gastroenterology, University of Navarre Clinic, Healthcare Research Institute of Navarre, Pamplona, Spain
| | - Reuma Margalit Yehuda
- Department of Gastroenterology, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Luca Elli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristiano Spada
- Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy
| | - Mauro Bruno
- Gastroenterology and Digestive Endoscopy Unit, "Città della Salute e della Scienza" Hospital, Torino, Italy
| | | | | | - Aymeric Becq
- Gastroenterology and Endoscopy Department, University Hospital Henri Mondor, Assistance Publique - Hôpitaux de Paris, 94000, Créteil, France
| | - Gareth Corbett
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK
| | - Antoine Martin
- Gastroenterology Unit, Bicetre Hospital, Le Kremlin-Bicêtre, France
| | - Alexander Robertson
- Department of Gastroenterology, Western General Hospital, Edinburgh EH4 2XU, UK
| | | | - Edward Despott
- Royal Free Unit for Endoscopy, The Royal Free Hospital and UCL Institute for Liver and Digestive Health, London, UK
| | - Maria Elena Riccioni
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Reena Sidhu
- Academic Department of Gastroenterology and Hepatology, Sheffield Teaching Hospitals, Sheffield, United Kingdom
| | - Laura Calavas
- Gastroenterology and Endoscopy Unit, Hospices Civils de Lyon, Hôpital E. Herriot, Lyon, France
| | - Pierre Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, MSD 2090 Msida, Malta
| | - Adam Finta
- Department of Gastroenterology, Endo-Kapszula Health Center and Endoscopy Unit, Székesfehérvár 8000, Hungary
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal, Attikon University General Hospital, Athens, Greece
| | | | - Julien Kirchgesner
- Department of Gastroenterology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Alfonso Elosua
- Gastroenterology Unit, Hospital García Orcoyen, 31200 Estella, Spain
| | - Deirdre McNamara
- Department of Gastroenterology, Tallaght University Hospital and School of Medicine Trinity College Dublin, Dublin, Ireland
| | - Xavier Dray
- Center for digestive endoscopy, Sorbonne University, Saint Antoine Hospital, APHP Paris, Paris, France
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Ohmiya N, Oka S, Nakayama Y, Iwama I, Nakamura M, Shimizu H, Sumioka A, Abe N, Kudo T, Osawa S, Honma H, Okuhira T, Mtsufuji S, Imaeda H, Ota K, Matsuoka R, Hotta N, Inoue M, Nakaji K, Takamaru H, Ozeki K, Kobayashi T, Hosoe N, Tajiri H, Tanaka S. Safety and efficacy of the endoscopic delivery of capsule endoscopes in adult and pediatric patients: Multicenter Japanese study (AdvanCE-J study). Dig Endosc 2022; 34:543-552. [PMID: 34379849 DOI: 10.1111/den.14104] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIM We retrospectively determined the safety and efficacy of the endoscopic delivery (ED) of capsule endoscopes. METHODS We enrolled 10,156 patients who underwent small bowel capsule endoscopy (SBCE), 3182 who underwent patency capsule (PC), and 1367 who underwent colon capsule endoscopy (CCE), at 11 gastroenterological and nine pediatric centers. RESULTS Small bowel capsule endoscopies, PCs, and CCEs were endoscopically delivered to 546 (5.4%), 214 (6.7%), and 14 (1.0%) patients, respectively. Only mild complications occurred for 21.6% (167/774), including uneventful mucosal damage, bleeding, and abdominal pain. Successful ED of SBCE to the duodenum or jejunum occurred in 91.8% and 90.7% of patients aged <16 years and ≥16 years, respectively (P = 0.6661), but the total enteroscopy rate was higher in the first group (91.7%) than in the second (76.2%, P < 0.0001), for whom impossible ingestion (87.3%) was significantly more common than prolonged lodging in the stomach (64.2%, P = 0.0010). Successful PC and CCE delivery to the duodenum occurred in 84.1% and 28.6%, thereafter the patency confirmation rate and total colonoscopy rate was 100% and 61.5%, respectively. The height, weight, and age cutoff points in predicting spontaneous ingestion were 132 cm, 24.8 kg, and 9 years 2 months, respectively, in patients aged <16 years. Patients aged ≥16 years could not swallow the SBCEs mainly due to dysphagia (75.0%); those who retained it in the esophagus due to cardiac disease (28.6%), etc. and in the stomach due to diabetes mellitus (15.7%), etc. CONCLUSIONS: This large-scale study supports the safety and efficacy of ED in adult and pediatric patients. UMIN000042020.
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Affiliation(s)
- Naoki Ohmiya
- Departments of Gastroenterology and Advanced Endoscopy, Fujita Health University School of Medicine, Aichi, Japan
| | - Shiro Oka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshiko Nakayama
- Department of Pediatrics, Shinshu University School of Medicine, Nagano, Japan
| | - Itaru Iwama
- Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hirotaka Shimizu
- Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiko Sumioka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Naoki Abe
- Division of Infectious Diseases and Immunology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Takahiro Kudo
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Osawa
- Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hitoshi Honma
- Department of Gastroenterology and Endocrinology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Takeru Okuhira
- Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shoji Mtsufuji
- Department of Gastroenterology, Kyoto Kujo Hospital, Kyoto, Japan
| | - Hiroyuki Imaeda
- Department of Gastroenterology, Saitama Medical University, Saitama, Japan
| | - Kazuhiro Ota
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Ryo Matsuoka
- Department of Pediatrics, Fuji City General Hospital, Shizuoka, Japan
| | - Naoki Hotta
- Department of Internal Medicine, Masuko Memorial Hospital, Aichi, Japan
| | - Mikihiro Inoue
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | | | | | - Keiji Ozeki
- Departments of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Taku Kobayashi
- Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Naoki Hosoe
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
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Endoscopic Delivery Method Using a Retrieval Net for Patients with Small-Bowel Capsule Endoscopy Stagnation in the Stomach. Gastroenterol Res Pract 2021; 2021:3216193. [PMID: 34956361 PMCID: PMC8702352 DOI: 10.1155/2021/3216193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/26/2021] [Indexed: 11/23/2022] Open
Abstract
With the increasing use of capsule endoscopy (CE), screening tests for the small bowel can be performed with minimal invasiveness. However, occasionally, the entire small bowel cannot be observed because of decreased peristalsis of the stomach. For such cases, we perform delivery of CE by an endoscope. We retrospectively examined the usefulness of the endoscopic delivery method using a retrieval net for patients with CE stagnation in the stomach. From 2,270 patients who underwent small-bowel CE at Hiroshima University Hospital from January 2013 to January 2020, 29 consecutive patients (1.3% of the total number) in whom the small bowel could not be observed due to CE stagnation in the stomach at the time of the initial CE underwent the endoscopic delivery method using a retrieval net for secondary small-bowel CE. This study included 16 male (55%) and 13 female (45%) patients with a mean age of 69.2 ± 13.2 years. 11 patients (38%) had a history of gastrointestinal surgical resection. The entire small bowel could be observed in 19 patients (66%), and CE reached the terminal ileum in the remaining patients. A history of gastrointestinal surgical resection was significantly more frequent in the group where the entire small bowel could not be observed. The rate of small-bowel lesion detection was 55% (16/29). There were no adverse events associated with our endoscopic delivery method. Thus, the endoscopic delivery method using a retrieval net for patients with initial CE stagnation in the stomach may be safe and useful for the detection of small-bowel lesions.
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Feasibility and diagnostic yield of small-bowel capsule endoscopy in patients with surgically altered gastric anatomy: the SAGA study. Gastrointest Endosc 2021; 94:589-597.e1. [PMID: 33848508 DOI: 10.1016/j.gie.2021.03.934] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Little is known about small-bowel (SB) capsule endoscopy (CE) in patients with a history of gastric surgery. This study aims to evaluate the feasibility and diagnostic yield (DY) of orally ingested SB-CE in patients with surgically altered gastric anatomy. METHODS Twenty-four European centers retrospectively identified patients who had SB-CE after total or subtotal gastrectomy. The primary outcome was the DY of SB-CE (intermediate P1 to highly P2 relevant findings). Secondary outcomes were gastric and SB transit times, completion, cleanliness, and adverse event rates. RESULTS Studied were 248 procedures from 243 patients (mean age, 62 years) with a history of partial gastrectomy (Billroth I, 13.1%; Billroth II, 34.6%), total gastrectomy (7.4%), Whipple procedure (12.8%), sleeve gastrectomy (7.2%), or gastric bypass surgery (24.7%). Obscure GI bleeding was the most frequent indication (85.1%). SB completion rate was 84.3%. One capsule retention in the SB was noted (adverse event rate, .4%). Median SB transit time was 286 minutes (interquartile range [235; 387]). Cleanliness was rated as adequate in 92.1% of procedures. After exclusion of abnormalities found at the upper anastomotic site, the DY was 43.6%, with inflammatory/ulcerated lesions observed more frequently (23.4%) than vascular lesions (21.0%). CONCLUSIONS SB-CE seems to be feasible and safe in selected patients with a history of major gastric surgery and comes with a high DY. The spectrum of abnormal SB findings in these patients may be different from what is known from the literature in nonoperated patients.
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Li J, Ren M, Yang J, Zhao Y, Li Y, Zhang D, Wu F, Zhang Z, Lu X, Ren L, He S, Lu G. Screening value for gastrointestinal lesions of magnetic-controlled capsule endoscopy in asymptomatic individuals. J Gastroenterol Hepatol 2021; 36:1267-1275. [PMID: 33000488 DOI: 10.1111/jgh.15282] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/16/2020] [Accepted: 09/25/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM Most patients with gastric tumors and precancerous lesions are asymptomatic, which often results in delayed diagnosis and treatment. Compared with conventional gastroscopy and capsule endoscopy, magnetic-controlled capsule endoscopy is a non-invasive, effective, and cost-efficient diagnostic modality for gastric examination. We retrospectively investigated magnetic-controlled capsule endoscopy as a screening tool for gastrointestinal lesions (particularly gastric tumors and precancerous lesions) in asymptomatic individuals. METHODS In this retrospective study, 1757 patients who voluntarily underwent magnetic-controlled capsule endoscopy between January and December 2019 at nine medical centers across Shaanxi province based on strict inclusion and exclusion criteria were enrolled. The primary outcomes were gastric tumor and precancerous lesion detection rates and procedural safety. RESULTS The upper and lower gastrointestinal lesion detection rates were 98.35% (1728/1757) and 21.61% (78/361), respectively; 2.28% of patients were diagnosed with gastric tumors including gastric cancer (4/1757) and submucosal tumors (36/1757). Three types of precancerous lesions were found in 591 patients (33.64%), including chronic atrophic gastritis (23.16%), gastric polyp (10.98%), and gastric ulcer (2.96%). For patients aged over 40 years, the detection rate of precancerous lesions was higher (14.36% vs 42.58%, P < 0.001). No patient was diagnosed with small intestinal cancer. No adverse events occurred. CONCLUSIONS Magnetic-controlled capsule endoscopy could be used as a promising novel screening modality for diagnosis of gastrointestinal lesions in asymptomatic individuals, specifically gastric tumors and precancerous lesions, with the advantages of safety, non-invasiveness, effectiveness, and cost-efficiency.
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Affiliation(s)
- Jing Li
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mudan Ren
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiahui Yang
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Zhao
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yarui Li
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dan Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fangli Wu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhiyong Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xinlan Lu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Li Ren
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuixiang He
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guifang Lu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Wang YC, Pan J, Liu YW, Sun FY, Qian YY, Jiang X, Zou WB, Xia J, Jiang B, Ru N, Zhu JH, Linghu EQ, Li ZS, Liao Z. Adverse events of video capsule endoscopy over the past two decades: a systematic review and proportion meta-analysis. BMC Gastroenterol 2020; 20:364. [PMID: 33138792 PMCID: PMC7607645 DOI: 10.1186/s12876-020-01491-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/07/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A full spectrum of video capsule endoscopy (VCE) adverse events over the past two decades has not been evaluated. We aimed to determine pooled rates, predictors and temporal-trend of VCE adverse events over the past two decades. METHODS Systematic search of PubMed and EMBASE for English-language publications reporting VCE adverse events (January 1, 2000 to March 31, 2019). Data were extracted independently by two investigators. Pooled VCE adverse event rates were calculated using the random or fixed model as appropriate. Predictors and temporal-trend of each adverse event were performed by meta-regression analyses. RESULTS In total, 402 studies were identified, including 108,079 VCE procedures. Rate of retention, swallow disorder, aspiration, technical failure, and procedural adverse events were 0.73% (95% confidence interval [CI] 0.59-0.89%), 0.75% (95% CI 0.43-1.13%), 0.00% (95% CI 0.00-0.00%), 0.94% (95% CI 0.65-1.28%), 0.67% (95% CI 0.32-1.10%), respectively; incomplete examination rate of esophagus, stomach, small bowel, and colon were 9.05%, 7.69%, 12.08%, 19.19%, respectively. Patency capsule reduced retention rate by 5.04%, whereas known inflammatory bowel disease increased retention rate by 4.29%. Elder was the risk and protective factor for small bowel incomplete examination (0.30%) and swallow disorder (- 0.72%), respectively. Rates of retention and small bowel incomplete examination significantly declined over time (P = .0006 and P < .0001).. CONCLUSIONS VCE adverse event rates were generally low, and retention and small bowel incomplete examination rates declined over the past two decades. Patients with known inflammatory bowel disease or elder should be alerted to high risk of retention or small bowel incomplete examination (PROSPERO: CRD42019139595).
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Affiliation(s)
- Yuan-Chen Wang
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Jun Pan
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Ya-Wei Liu
- Department of Gastroenterology, The First Medical Center of PLA General Hospital/Chinese PLA Postgraduate Military Medical School, 28 Fuxing Road, Beijing, 100853, China
| | - Feng-Yuan Sun
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Yang-Yang Qian
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Xi Jiang
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Wen-Bin Zou
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Ji Xia
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Bin Jiang
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Nan Ru
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Jia-Hui Zhu
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - En-Qiang Linghu
- Department of Gastroenterology, The First Medical Center of PLA General Hospital/Chinese PLA Postgraduate Military Medical School, 28 Fuxing Road, Beijing, 100853, China.
| | - Zhao-Shen Li
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China
| | - Zhuan Liao
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China.
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Gan HY, Peng TL, Su KH, Zhao LL, Jian LQ, Yang RJ, Zhang HX, Pan RY. Association between hypokalemia and small bowel capsule endoscopy completion rates in patients in South China: A prospective single-center study. Saudi J Gastroenterol 2019; 25:40-45. [PMID: 30479322 PMCID: PMC6373215 DOI: 10.4103/sjg.sjg_77_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND/AIMS Approximately 20-30% of small bowel capsule endoscopies (SBCEs) do not reach the cecum at the completion of the examination. We aimed to determine whether hypokalemia influences the completion rate and small bowel transit time (SBTT) of SBCE. PATIENTS AND METHODS From January to December 2017, 112 patients (18-75 years old) who underwent SBCE were assessed consecutively for enrolment in our study. On the day of the procedure, a blood test was performed prior to capsule ingestion. The completion rate, gastric transit time (GTT), SBTT, and diagnostic yield were recorded for each SBCE. RESULTS The SBCE completion rate was lower in the hypokalemia group than that in the normal potassium group (55.6% (15/27) vs. 76.5% (65/85), P = 0.036). The median GTT was 55.5 ± 47.1 min in the hypokalemia group and 46.7 ± 44.5 min in the normal potassium group (P > 0.05). The median SBTT was 412.8 ± 123.3 min in the hypokalemia group and 367.3 ± 172.5 min in the normal potassium group (P > 0.05). The diagnostic yields of the hypokalemia and normal potassium groups were 74.1% and 78.8%, respectively (P = 1.00). CONCLUSION Hypokalemia may decrease the SBCE completion rate. Physicians should consider the possibility of hypokalemia after bowel preparation because this condition is not rare. Potassium deficiencies should be rectified prior to performing SBCE procedures to increase the SBCE completion rate.
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Affiliation(s)
- Huo-Ye Gan
- Department of Gastroenterology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Guangdong, China,Address for correspondence: Dr. Huo-Ye Gan, Department of Gastroenterology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Area B24, Yinquan Road, Qingcheng District, Qingyuan City, Guangdong Province, China. E-mail:
| | - Tie-Li Peng
- Department of Gastroenterology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Kai-Hua Su
- Department of Gastroenterology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Lin-Li Zhao
- Department of Gastroenterology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Li-Qin Jian
- Department of Gastroenterology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Rong-Jiao Yang
- Department of Gastroenterology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Han-Xian Zhang
- Department of Gastroenterology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Ru-Yin Pan
- Department of Gastroenterology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Guangdong, China
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Shim KN, Jeon SR, Jang HJ, Kim J, Lim YJ, Kim KO, Song HJ, Lee HS, Park JJ, Kim JH, Chun J, Park SJ, Yang DH, Min YW, Keum B, Lee BI. Quality Indicators for Small Bowel Capsule Endoscopy. Clin Endosc 2017; 50:148-160. [PMID: 28391667 PMCID: PMC5398361 DOI: 10.5946/ce.2017.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 03/14/2017] [Accepted: 03/16/2017] [Indexed: 02/06/2023] Open
Abstract
Capsule endoscopy (CE) enables evaluation of the entire mucosal surface of the small bowel (SB), which is one of the most important steps for evaluating obscure gastrointestinal bleeding. Although the diagnostic yield of SB CE depends on many clinical factors, there are no reports on quality indicators. Thus, the Korean Gut Image Study Group (KGISG) publishes an article titled, “Quality Indicators for Small Bowel Capsule Endoscopy” under approval from the Korean Society of Gastrointestinal Endoscopy (KSGE). Herein, we initially identified process quality indicators, while the structural and outcome indicators are reserved until sufficient clinical data are accumulated. We believe that outcomes of SB CE can be improved by trying to meet our proposed quality indicators.
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Affiliation(s)
- Ki-Nam Shim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Seong Ran Jeon
- Department of Internal Medicine,Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hyun Joo Jang
- Department of Internal Medicine, Hallym University College of Medicine, Hwaseong, Korea
| | - Jinsu Kim
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun Jeong Lim
- Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea
| | - Kyeong Ok Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Hyun Joo Song
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Hyun Seok Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Jun Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hyun Kim
- Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
| | - Jaeyoung Chun
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Jung Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong-Hoon Yang
- Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Yang Won Min
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bora Keum
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Bo-In Lee
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
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Abstract
Wireless capsule endoscopy (CE) was introduced in 2000 as a less invasive method to visualize the distal small bowel in adults. Because this technology has advanced it has been adapted for use in pediatric gastroenterology. Several studies have described its clinical use, utility, and various training methods but pediatric literature regarding CE is limited. This clinical report developed by the Endoscopic and Procedures Committee of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition outlines the current literature, and describes the recommended current role, use, training, and future areas of research for CE in pediatrics.
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Barkin JA, Barkin JS. Video Capsule Endoscopy: Technology, Reading, and Troubleshooting. Gastrointest Endosc Clin N Am 2017; 27:15-27. [PMID: 27908514 DOI: 10.1016/j.giec.2016.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Video capsule endoscopy (VCE) has completed the endoscopic visualization of the entire luminal gastrointestinal tract. VCE can be performed in inpatients and outpatients, requires appropriate bowel preparation before the study, and can be administered via oral swallowing or endoscopic device placement into the small bowel based on outlined patient-dependent factors. Current commercially available VCE systems were reviewed and compared for individual features and attributes. This article focuses on preparation for VCE, currently available VCE technology, how to read a VCE study, and risks and contraindications to VCE.
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Affiliation(s)
- Jodie A Barkin
- Division of Gastroenterology, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 North West 14th Street, Clinical Research Building, Suite 1116 (D-49), Miami, FL 33136, USA.
| | - Jamie S Barkin
- Division of Gastroenterology, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 North West 14th Street, Clinical Research Building, Suite 1116 (D-49), Miami, FL 33136, USA
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11
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Stanich PP, Guido J, Kleinman B, Betkerur K, Porter KM, Meyer MM. Video capsule endoscopy completion and total transit times are similar with oral or endoscopic delivery. Endosc Int Open 2016; 4:E228-32. [PMID: 26878055 PMCID: PMC4751004 DOI: 10.1055/s-0041-110770] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 11/23/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND STUDY AIMS Video capsule endoscopy (VCE) is limited by incomplete procedures. There are also contraindications to the standard ingestion of the capsule that require endoscopic placement. Our aim was to compare the study completion rate of VCE after oral ingestion and endoscopic deployment. PATIENTS AND METHODS We performed a review of all VCE from April 2010 through March 2013. Inpatient and outpatient cohorts grouped by the method of capsule delivery were formed and compared. Multivariable logistic regression modeling was utilized adjusting for variables with a P value ≤ 0.1 in group comparisons. Log-rank analysis was used to compare transit times. RESULTS A total of 687 VCE were performed, including 316 inpatient (36 endoscopic deployment, 280 oral ingestion) and 371 outpatient (20 endoscopic deployment, 351 oral ingestion). For VCE on hospitalized patients, the completion rates were similar after endoscopic deployment and oral ingestion (72 % vs 73 %, P = 0.94). The completion rates were also similar for ambulatory patients (90 % vs 87 %, P = 0.69). There remained no difference after multivariable modeling for inpatients (P = 0.71) and outpatients (P = 0.46). Total transit times were not significantly different. CONCLUSIONS VCE completion rates and total transit times are similar after oral or endoscopic deployment for both hospitalized and ambulatory patients. Endoscopic placement is effective in patients with contraindications to standard oral ingestion, but should otherwise be avoided to limit unnecessary procedural risks and costs.
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Affiliation(s)
- Peter P. Stanich
- Section of Capsule Endoscopy, Division of Gastroenterology, Hepatology & Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - John Guido
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Bryan Kleinman
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States,Division of Gastroenterology; Einstein Medical Center, Philadelphia, Pennsylvania, United States
| | - Kavita Betkerur
- College of Medicine, The Ohio State University, Columbus, Ohio, United States,Department of Internal Medicine, UC Davis School of Medicine, Sacramento, California, United States
| | - Kyle M. Porter
- Center for Biostatistics, The Ohio State University, Columbus, Ohio, United States
| | - Marty M. Meyer
- Section of Capsule Endoscopy, Division of Gastroenterology, Hepatology & Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States,Corresponding author Marty M. Meyer, MD 395 W 12th Ave, Suite 200Columbus, OH 43210+1-614-293-4191+1-614-293-8518
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12
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The effect of macrogol administration on the quality of macroscopic images and transit time in canine capsule endoscopy. Pol J Vet Sci 2014; 17:673-9. [DOI: 10.2478/pjvs-2014-0098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
The present experiment evaluated the quality of macroscopic images and the mean time of capsule passage through different sections of the gastrointestinal tract in dogs subjected to different preparation protocols before capsule endoscopy. In the first examination, the colonoscopy preparation protocol was applied, and in the second examination, the animals were administered macrogol. The study revealed that macrogol administration before capsule endoscopy significantly improved the quality of macroscopic images. The colonoscopy preparation protocol may not support accurate visualization of the large bowel mucosa and, in selected patients, also the small bowel mucosa. Macrogol administration had no effect on capsule transit time through the alimentary canal. Capsules used in endoscopic evaluations of the small bowel in humans may have limited applications in macroscopic examinations of large bowel mucosa in dogs.
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