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Esaki M. Endoscopic delivery: A solution for capsule endoscopy in patients with swallowing disorders, difficulties, or impaired gastrointestinal motility. Dig Endosc 2022; 34:472-473. [PMID: 35165931 DOI: 10.1111/den.14242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 02/08/2023]
Affiliation(s)
- Motohiro Esaki
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 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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Macías E, Elosua González A, Juanmartiñena JF, Borda Martín A, Elizalde I, Fernández-Urién I. Can we predict an incomplete capsule endoscopy? Results of a multivariate analysis using a logistic regression model. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 114:329-334. [PMID: 34517709 DOI: 10.17235/reed.2021.7320/2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Small bowel capsule endoscopy (SBCE) does not reach the cecum within the battery lifetime in approximately 15-35% of patients. Incomplete examinations result in diagnostic delays and increase the economic burden. To date, risk factors for incomplete examinations have been described with contradictory results. The aims of this study were to analyze rate and identify risk factors for incomplete examinations, excluding capsule retentions, in a large cohort of patients. METHODS Data from 1894 consecutive SBCE examinations performed from January 2009 to December 2015 were analyzed. Variables recorded included demographics, past medical and surgical history, biochemical parameters and procedure characteristics. The rate of incomplete examinations, excluding capsule retentions, was calculated and a multivariate analysis using a logistic regression model was performed in order to evaluate predictive factors. RESULTS The incidence of incomplete examinations, excluding capsule retentions, was 10.1% (187 incomplete procedures). The multivariate analysis showed that age >65 years, gastric transit time >41 minutes and SB transit time >286 minutes are predictive factors for incomplete examinations, increasing the probability of this event by 199% (OR:1.99; CI95%:1.34-2.95), 260% (OR:2.60; CI95%:1.72-3.93) and 352% (OR:3.52; CI95%:2.26-5.48), respectively. CONCLUSIONS Age >65 years, gastric transit time >41 minutes and SB transit time >286 minutes are predicting factors for incomplete examinations excluding capsule retentions. Both age and gastric transit time events are known before procedure ending. Therefore, pharmacologic or endoscopic measures may be taken into account to avoid incomplete examinations.
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Affiliation(s)
- Elena Macías
- Gastroenterology, Complejo Hospitalario de Navarra, España
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Stiller J, Defarges AM, Brisson BA, Bersenas AME, Pearl DL. Feasibility, complications, and quality of visualization using video capsule endoscopy in 40 dogs with overt or questionable gastrointestinal bleeding. J Vet Intern Med 2021; 35:1743-1753. [PMID: 33993552 PMCID: PMC8295713 DOI: 10.1111/jvim.16153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 04/25/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
Background Prospective studies describing video capsule endoscopy (VCE), its feasibility, and complications in dogs are limited. Objective To assess VCE, quality of visualization, complications, and risk factors for incomplete studies in dogs with overt or questionable gastrointestinal bleeding (GIB). Animals Forty dogs with overt or questionable GIB. Methods Prospective, multicenter, interventional study. From August 2017 to March 2020, dogs were examined by VCE (ALICAM) because of overt or questionable GIB. Reported outcomes included diagnostic results of VCE study, quality of visualization, and complications. Risk factors for incomplete studies were evaluated using logistic regression. Results In total, 40 dogs (13 overt, 27 questionable GIB) were included. The capsules were administered PO in 29 and endoscopically in 11 dogs (6 duodenum, 5 stomach). One capsule was not retrieved. In 24 of 39 recordings, bleeding lesions were identified (10 overt GIB, 14 questionable GIB). Overall, the quality of visualization was poor to limited in the stomach and colon, and adequate to good in the small intestine. The most common complication was an incomplete study in 15/39 studies, particularly after oral administration (13/28). Risk factors for incomplete study after oral administration included administration of simethicone or opioids, chronic enteropathy, and capsule gastric transit time >6 hours. Conclusions and Clinical Importance Video capsule endoscopy can be used to diagnose a variety of lesions causing bleeding in the gastrointestinal tract of dogs with questionable GIB. Incomplete studies are the most common complications in dogs after oral administration of capsules.
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Affiliation(s)
- Jenny Stiller
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.,Small Animal Clinic, College of Veterinary Medicine, University of Leipzig, Leipzig, Saxony, Germany
| | - Alice M Defarges
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Brigitte A Brisson
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Alexa M E Bersenas
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - David L Pearl
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Giordano A, González AE, Ceballos FS, Carretero-Ribón C, Aicart-Ramos M, Valenzuela JE, Alonso-Lázaro N, Martín-Lorente JL, Gálvez-Castillo C, Pons-Beltrán V, Fernández-Urién I, González-Suárez B. Oral ingestion versus endoscopic delivery of endoscopic capsule in patients with previous gastrointestinal surgery (ORENCES study): A Spanish multicentre observational study. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 44:680-686. [PMID: 33259828 DOI: 10.1016/j.gastrohep.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/09/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Small Bowel Capsule Endoscopy is the first-choice technique for investigating the majority of small bowel diseases. Its most common complications are related to incomplete examinations and capsule retention. There is no consensus on how patients with previous gastrointestinal surgery should receive the capsule. OBJECTIVE The primary endpoint was to compare the rate of complete small-bowel examinations (completion rate) between oral ingestion and endoscopic delivery of the capsule. The secondary endpoint was to compare diagnostic yield and adverse events in the two groups. METHODS A retrospective observational study was conducted in nine hospitals in Spain. Demographic data, previous surgery, indication for capsule endoscopy, intestinal transit time, diagnosis, completion rate (percentage of capsules reaching the caecum), diagnostic yield (percentage of results compatible with indication for the exam) and adverse events were collected. RESULTS From January 2009 to May 2019 fifty-seven patients were included (39 male, mean age 66±15 years). The most common indications for the exam were "overt" (50.9%) and "occult" (35.1%) small bowel bleeding. Previous Billroth II gastrectomy and Roux-en-Y gastric bypass were present in 52.6% and 17.5% of patients respectively. The capsule was swallowed in 34 patients and placed endoscopically in 23 patients. No significant differences were observed between the oral ingestion and endoscopic delivery groups in terms of completion rate (82.4% vs. 78.3%; p=0.742), diagnostic yield (41.2% vs. 52.2%; p=0.432) or small bowel transit time (301 vs. 377min, p=0.118). No capsule retention occurred. Only one severe adverse event (anastomotic perforation) was observed in the endoscopic delivery group. CONCLUSIONS In our case series, there were no significant differences between oral ingestion and endoscopic delivery in terms of completion rate, diagnostic yield or safety. Being less invasive, oral ingestion of the capsule should be the first-choice method in patients with previous gastrointestinal surgery.
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Affiliation(s)
- Antonio Giordano
- Endoscopy Unit, Department of Gastroenterology, Hospital Clínic of Barcelona, Carrer de Villarroel 170, 08036 Barcelona, Spain
| | - Alfonso Elosua González
- Department of Gastroenterology, Hospital García Orcoyen, Calle Sta. Soria 22, 31200 Estella, Spain
| | - Francisco Sánchez Ceballos
- Department of Digestive Diseases, Hospital Clínico San Carlos, Calle del Prof Martín Lagos, 28040 Madrid, Spain
| | - Cristina Carretero-Ribón
- Department of Gastroenterology, Clínica Universidad de Navarra, Av. de Pío XII 36, 31008 Pamplona, Spain
| | - Marta Aicart-Ramos
- Department of Gastroenterology, Hospital Universitario Ramón y Cajal, M-607 km. 9, 28034 Madrid, Spain
| | - Juan Egea Valenzuela
- Department of Digestive Diseases, Hospital Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, 30120 Murcia, Spain
| | - Noelia Alonso-Lázaro
- Gastrointestinal Endoscopy Unit, Digestive Diseases Department, Hospital Universitari La Fe, Avinguda de Fernando Abril Martorell, 46026 Valencia, Spain
| | - José Luis Martín-Lorente
- Department of Gastroenterology, Hospital Universitario de Burgos, Av. Islas Baleares 3, 09006 Burgos, Spain
| | - Consuelo Gálvez-Castillo
- Department of Gastroenterology, Hospital Clínic Universitari de València, Av. de Blasco Ibáñez 17, 46010 Valencia, Spain
| | - Vicente Pons-Beltrán
- Gastrointestinal Endoscopy Unit, Digestive Diseases Department, Hospital Universitari La Fe, Av. de Fernando Abril Martorell, 46026 Valencia, Spain
| | - Ignacio Fernández-Urién
- Department of Gastroenterology, Complejo Hospitalario de Navarra, Calle de Irunlarrea 3, 31008 Pamplona, Spain
| | - Begoña González-Suárez
- Endoscopy Unit, Department of Gastroenterology, Hospital Clínic of Barcelona, Carrer de Villarroel 170, 08036 Barcelona, Spain.
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Iwama I, Shimizu H, Nambu R, Okuhira T, Kakuta F, Tachibana N, Abe N, Honma H, Kudo T, Nakayama Y. Efficacy and safety of a capsule endoscope delivery device in children. Eur J Gastroenterol Hepatol 2019; 31:1502-1507. [PMID: 31464784 DOI: 10.1097/meg.0000000000001513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES This multicenter, cross-sectional study aimed to elucidate the efficacy and safety of the AdvanCE capsule endoscope delivery device for children in Japan. METHODS The present study analyzed 183 cases of small bowel capsule endoscope (SBCE) insertion performed using the AdvanCE in 154 patients aged less than 18 years at participating institutions between 2013 and 2017. Statistical analyses were conducted to identify factors contributing to the completion rate for the entire small intestine examination, small intestine transit time, adverse events and technical issues. RESULTS The commonest reason for using the AdvanCE was the patient's inability to swallow the SBCE, which was attributed to young age. SBCE was successfully delivered into the stomach or duodenum in 180 cases and was placed in the duodenum in 90% patients. In 89% patients, the entire small intestine was completely examined, and in 63% patients, findings leading to a new diagnosis or involving changing or maintaining the treatment strategy were obtained. No severe adverse events were observed; however, mild adverse events were observed in 35% patients. No factors considerably contributed to the completion rate for the entire small intestine examination or small intestine transit time and onset of technical issues. The factors that contributed to mild adverse events included intravenous anesthesia, technical issue, and absence of prior insertion of a patency capsule using the AdvanCE. CONCLUSION The AdvanCE is well tolerated and effective for children.
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Affiliation(s)
- Itaru Iwama
- Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama
| | - Hirotaka Shimizu
- Division of Gastroenterology, National Center for Child Health and Development
| | - Ryusuke Nambu
- Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama
| | - Takeru Okuhira
- Department of Pediatrics, Osaka Medical College, Takatsuki
| | - Fumihiko Kakuta
- Division of General Medicine and Gastroenterology, Miyagi Prefectural Children's Hospital, Sendai
| | - Nao Tachibana
- Division of Gastroenterology, Tokyo Metropolitan Children's Medical Center, Fuchu
| | - Naoki Abe
- Division of Infectious Diseases and Immunology, Aichi Child Health and Medical General Center, Obu
| | - Hitoshi Honma
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takahiro Kudo
- Department of Pediatrics, Juntendo University, Tokyo
| | - Yoshiko Nakayama
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
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Sellers E, Brock A. Safety and efficacy of wireless capsule endoscopy in patients with surgically altered upper gastrointestinal anatomy. LAPAROSCOPIC, ENDOSCOPIC AND ROBOTIC SURGERY 2018. [DOI: 10.1016/j.lers.2017.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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The Effect of Prucalopride on Small Bowel Transit Time in Hospitalized Patients Undergoing Capsule Endoscopy. Can J Gastroenterol Hepatol 2017; 2017:2696947. [PMID: 29333428 PMCID: PMC5733169 DOI: 10.1155/2017/2696947] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 09/14/2017] [Accepted: 11/09/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The inpatient status is a well-known risk factor for incomplete video capsule endoscopy (VCE) examinations due to prolonged transit time. We aimed to evaluate the effect of prucalopride on small bowel transit time for hospitalized patients undergoing VCE. METHODS We included all hospitalized patients who underwent VCE at a tertiary academic center from October 2011 through September 2016. A single 2 mg dose of prucalopride was given exclusively for all patients who underwent VCE between March 2014 and December 2015. VCE studies were excluded if the capsule was retained or endoscopically placed, if other prokinetic agents were given, in cases with technical failure, or if patients had prior gastric or small bowel resection. RESULTS 442 VCE were identified, of which 68 were performed in hospitalized patients. 54 inpatients were included, of which 29 consecutive patients received prucalopride. The prucalopride group had a significantly shorter small bowel transit time compared to the control group (92 versus 275.5, p < 0.001). There was a trend for a higher completion rate in the prucalopride group (93.1% versus 76%, p = 0.12). CONCLUSIONS Our results suggest that the administration of prucalopride prior to VCE is a simple and effective intervention to decrease small bowel transit time.
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Bandorski D, Kurniawan N, Baltes P, Hoeltgen R, Hecker M, Stunder D, Keuchel M. Contraindications for video capsule endoscopy. World J Gastroenterol 2016; 22:9898-9908. [PMID: 28018097 PMCID: PMC5143757 DOI: 10.3748/wjg.v22.i45.9898] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 10/09/2016] [Accepted: 11/16/2016] [Indexed: 02/06/2023] Open
Abstract
Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn’s disease, clinical signs of obstruction, prior radiation or surgical small bowel resection, a preceding test with the self-dissolving patency capsule can override this contraindication. Endoscopic placement of the capsule should be considered in patients with swallowing disorders to avoid aspiration. Esophageal or gastric motility disorders may require endoscopic capsule transport or application of prokinetics if the real-time viewer proofs delayed transit. In pregnant women, VCE should be restricted to urgent cases where diagnosis cannot be postponed after delivery, as data on safety are missing. There is theoretical and clinical evidence that patients with implanted cardiac devices such as a pacemaker, cardioverters or left heart assist devices, can safely undergo VCE in spite of still existing contraindication by manufacturers. Children from the age of 2 years have safely undergone VCE. Although video capsules are not proven safe with magnetic resonance imaging (MRI), first single cases of patients incidentally undergoing MRI with an incorporated capsule have been reported, showing susceptibility artifacts but no signs of clinical harm.
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