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Wang H, Xie J, Ren L, Liang D, Xiong L, Liu L, Xu W, Gong S, Geng L, Chen P. Age Is a Risk Factor for Gastroscopy-Assisted Capsule Endoscopy in Children. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2023; 35:41-47. [PMID: 37966265 PMCID: PMC10837550 DOI: 10.5152/tjg.2023.22428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 03/06/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND/AIMS The aim of this study was to explore the risk factors for the incidence of gastroscopy-assisted capsule endoscopy and the small bowel transit time in pediatric patients who underwent capsule endoscopy examination. MATERIALS AND METHODS A retrospective analysis was performed to analyze the clinical data collected from pediatric patients who underwent capsule endoscopy examination. RESULTS A total of 239 pediatric patients were enrolled in this study. About 196 (82.0%) patients completed the entire small bowel capsule endoscopy examination, while 3 (1.3%) patients were subjected to capsule retention. Only age, not gender, height, body weight, body mass index, chief complaint, and intestinal preparation medications, has been identified as a risk factor for the incidence of gastroscopy-assisted capsule endoscopy (P < .05) by multivariate logistic regression. Further analysis showed that the small bowel transit time in the self-swallowed group was shorter than that in the gastroscopy-assisted group, while no significant difference was obtained in other factors, including intestinal preparation medications, metoclopramide, and lesions in the small intestine, which did not significantly affect small bowel transit time compared with the corresponding control group (P > .05). CONCLUSION A comprehensive assessment is required before performing capsule endoscopy, because age has been identified as a critical risk factor for the incidence of gastroscopy-assisted capsule endoscopy in pediatric patients.
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Affiliation(s)
- Hongli Wang
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jing Xie
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lu Ren
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Defeng Liang
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Liya Xiong
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Liying Liu
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wanfu Xu
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Sitang Gong
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lanlan Geng
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Peiyu Chen
- Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
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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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Alsahafi M, Cramer P, Chatur N, Donnellan F. The impact of inpatient capsule endoscopy on the need for therapeutic interventions in patients with obscure gastrointestinal bleeding. Saudi J Gastroenterol 2019; 26:53-60. [PMID: 31997779 PMCID: PMC7045773 DOI: 10.4103/sjg.sjg_415_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND/AIM There are limited data evaluating the impact of inpatient video capsule endoscopy (VCE) on the need for therapeutic interventions in hospitalized patients with obscure gastrointestinal bleeding (OGIB). The objective of this study was to determine the impact of inpatient VCE on the need for therapeutic interventions and rehospitalization for recurrent bleeding. PATIENTS AND METHODS Hospitalized patients who underwent VCE for OGIB indication were retrospectively included. Clinical data were collected including therapeutic interventions performed after VCE. Specific therapeutic interventions were defined as the medical, endoscopic, or surgical treatment directly targeting the cause of OGIB. Patients were followed up to determine the rate of rehospitalization. RESULTS A total of 48 inpatient VCE were identified, of which 43 VCE were performed for OGIB indication and were included for analysis. The completion rate and the diagnostic yield were 78.5% and 55.8%, respectively. Subsequent specific therapeutic interventions were performed in 65.2% and 5.8% of patients with positive and negative VCE, respectively (P < 0.001). After a median follow up of 30 months (minimum 12, maximum 58), rehospitalization for recurrent bleeding occurred in 30.4% and 17% of patients with positive and negative VCE, respectively. Patients with angiodysplasia on VCE were significantly more likely to be readmitted (P = 0.02). Throughout the course of the follow-up, only 2 (11.7%) patients with negative VCE underwent specific therapeutic interventions. CONCLUSION Inpatient VCE is an effective tool to identify patients who need specific therapeutic interventions. Patients with negative VCE are unlikely to be readmitted or require specific therapeutic interventions in the index admission.
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Affiliation(s)
- Majid Alsahafi
- Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada,Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,Address for correspondence: Dr. Majid Alsahafi, Department of Medicine, King Abdulaziz University, Building 10, second Floor, P.O. Box 80215, Jeddah - 21589, Saudi Arabia. E-mail:
| | - Paula Cramer
- Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nazira Chatur
- Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fergal Donnellan
- Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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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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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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