Högberg L, Nordwall M, Stenhammar L
Dept. of Paediatrics, Linköping University, Norrköping Hospital, Sweden.
Scand J Gastroenterol. 2001 Nov;36(11):1230-2. doi: 10.1080/00365520152584905.
Small-bowel biopsy is a well-established technique in the evaluation of children with intestinal malabsorption, e.g. coeliac disease. The biopsy is performed endoscopically or with a peroral capsule instrument. The aim of the present retrospective study was to compare the single-port Watson capsule with the double-port Storz capsule with regard to procedure and fluoroscopy time, complications and failure rate.
All 1,078 peroral small-bowel biopsies performed at our department during 1989-99 were studied. In 387 of these, the Watson capsule was used and in the remaining 691 the Storz capsule. Median age of the children was 2.5 years. About one-third of the children were premedicated with the prokinetic drug cisapride and as sedatives alimemazine or diazepam orally. Two-thirds of the children were given metoclopramide along with midazolam intravenously. The biopsies were performed under intermittent fluoroscopy.
The median biopsy procedure time was significantly shorter with the Storz capsule (7 min) compared to the Watson capsule (10 min) (P < 0.05). The median fluoroscopy time was 5 sec with the Storz capsule and 8 sec with the Watson capsule (P < 0.01). The failure rate did not differ significantly between the two capsule types: 10.3% (Watson) and 7.7% (Storz). One potential but no serious complication occurred.
Providing that effective sedation is available, small-bowel biopsy with a peroral capsule, and the Storz double-port multibiopsy capsule in particular, is a safe and fast method exposing the child to a minimal radiation dose.
小肠活检是评估儿童肠道吸收不良（如乳糜泻）的一项成熟技术。活检可通过内镜或经口胶囊器械进行。本回顾性研究的目的是比较单端口沃森胶囊和双端口斯托兹胶囊在操作过程、透视时间、并发症和失败率方面的差异。
对1989年至1999年在我科进行的1078例经口小肠活检进行研究。其中387例使用沃森胶囊，其余691例使用斯托兹胶囊。儿童的中位年龄为2.5岁。约三分之一的儿童预先使用促动力药物西沙必利以及口服镇静剂阿利马嗪或地西泮进行预处理。三分之二的儿童静脉注射甲氧氯普胺和咪达唑仑。活检在间歇性透视下进行。
与沃森胶囊（10分钟）相比，斯托兹胶囊的中位活检操作时间显著更短（7分钟）（P < 0.05）。斯托兹胶囊的中位透视时间为5秒，沃森胶囊为8秒（P < 0.01）。两种胶囊类型的失败率无显著差异：沃森胶囊为10.3%，斯托兹胶囊为7.7%。发生了1例潜在但不严重的并发症。
只要有有效的镇静措施，经口胶囊进行小肠活检，尤其是斯托兹双端口多活检胶囊，是一种安全、快速的方法，可使儿童接受的辐射剂量最小。
