Ambardar S, Arnell T D, Whelan R L, Nihalani A, Forde K A
Division of General Surgery, New York Presbyterian Hospital-Columbia Campus, 161 F Washington Avenue #821, New York, NY 10032, USA.
Surg Endosc. 2005 Jul;19(7):897-901. doi: 10.1007/s00464-004-8948-0. Epub 2005 May 5.
Although magnetic endoscope imaging of the colonoscope via the Endoscope Positioning Detecting Unit (EPDU) has been studied to some extent in Europe, its application in the United States has been limited. The purposes of this study were to determine whether the technique enabled for accurate localization of the lesion and to determine if and how the device facilitated scope insertion and completion of the colonoscopic exam.
Outpatient colonoscopies using the EPDU were performed by three experienced surgical endoscopists over a 5-month period. A specialized scope with electromagnetic coils or a regular scope with a magnetic probe insert in the instrument channel was used for the duration of the examination to identify loops and localize pathology.
A total of 80 colonoscopies were performed with the device. In two patients, the probe insert was removed prior to completion of the procedure; thus, the total number of examinations included in the study was 78. The EPDU was used in conjunction with transillumination to estimate the location of polyps or cancers in the 33 patients (42%) in whom such lesions were found. In the four patients who subsequently underwent operation, the lesion's location as estimated by EPDU was verified. In regard to the usefulness of the device during insertion, the EPDU led to the discovery of loops and to the application of pressure that resulted in prompt completion of the examination in 28% of cases (deemed most useful). In 33% of cases, the device identified loops and led to the application of abdominal wall pressure and early position changes, thus facilitating the examination; however it did not lead to its immediate or rapid completion. In 39% of cases, the device was not required or used for insertion due to the simple nature of the examination.
The EPDU was accurate in estimating lesion location. The device also holds promise as an aid in the completion of difficult exams (about 30% of cases in this study).
尽管欧洲已在一定程度上研究了通过内窥镜定位检测单元（EPDU）对结肠镜进行磁性内窥镜成像，但该技术在美国的应用一直有限。本研究的目的是确定该技术是否能够实现病变的准确定位，并确定该设备是否以及如何有助于结肠镜插入和结肠镜检查的完成。
由三位经验丰富的外科内镜医师在5个月的时间内使用EPDU进行门诊结肠镜检查。在检查期间，使用带有电磁线圈的专用结肠镜或在器械通道中插入磁探头的常规结肠镜来识别肠袢并定位病变。
使用该设备共进行了80例结肠镜检查。两名患者在检查完成前取出了探头插入物；因此，本研究纳入的检查总数为78例。在发现息肉或癌症的33例患者（42%）中，EPDU与透照法结合使用以估计病变的位置。在随后接受手术的4例患者中，EPDU估计的病变位置得到了证实。关于该设备在插入过程中的有用性，EPDU导致发现肠袢并施加压力，从而在28%的病例中促使检查迅速完成（被认为最有用）。在33%的病例中，该设备识别出肠袢并导致施加腹壁压力和早期体位改变，从而便于检查；然而，这并未导致检查立即或快速完成。在39%的病例中，由于检查性质简单，不需要或未使用该设备进行插入操作。
EPDU在估计病变位置方面是准确的。该设备也有望辅助完成困难的检查（本研究中约30%的病例）。
