Cheung H Y, Chung C C, Kwok S Y, Tsang W W, Li M K
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China.
Endoscopy. 2006 Mar;38(3):214-7. doi: 10.1055/s-2005-921172.
Although magnetic endoscope imaging (MEI) has been reported to improve the performance of colonoscopy, so far only a few randomized controlled studies have been published supporting its adjunctive role. This randomized study was designed to evaluate the role of MEI on the overall performance of colonoscopy.
Patients admitted for elective colonoscopy were recruited. They were randomly allocated into two groups, either with an MEI view (study group) or without (control group). Examinations were performed by one of the two designated, trained endoscopists. The primary end point was intubation time. Other outcome measures included completion rate, pain score graded by patients, and ease of procedure as reflected by the number of attempts at straightening the scope, the number of times of hand pressure was applied abdominally, and the need to change the patient's position. Endoscopists were also asked to score the ease of procedure. Finally, in the MEI group, endoscopists were asked to comment on whether MEI helped to locate colonic lesions during endoscopy.
In a 12-month period, 120 patients were recruited, with 60 patients in each group. The two groups were matched for age, gender distribution, and indications for colonoscopy. No complication occurred in either group. No significant difference was observed in the intubation time and colonoscopy completion rate. Other measures of ease of procedure and pain score were also similar. However, MEI was reported by endoscopists to be helpful in locating colonic lesions in 32 % of examinations with positive findings.
For trained endoscopists, the device confers no benefit in terms of performance improvement. The only identified benefit is in locating lesions. Thus, while the routine use of MEI cannot be recommended, the device could be selectively offered to patients for follow-up examination after local treatment, or to patients with small colorectal tumors in whom laparoscopic surgery is planned.
尽管已有报道称磁内镜成像（MEI）可提高结肠镜检查的性能，但迄今为止，仅有少数随机对照研究发表，支持其辅助作用。本随机研究旨在评估MEI在结肠镜检查整体性能方面的作用。
招募择期行结肠镜检查的患者。他们被随机分为两组，一组采用MEI观察（研究组），另一组不采用（对照组）。检查由两名指定的、经过培训的内镜医师之一进行。主要终点是插管时间。其他结局指标包括完成率、患者分级的疼痛评分，以及通过拉直结肠镜的尝试次数、腹部按压次数和改变患者体位的需求所反映的操作难易程度。内镜医师也被要求对操作难易程度进行评分。最后，在MEI组中，要求内镜医师评论MEI在结肠镜检查期间是否有助于定位结肠病变。
在12个月的时间里，共招募了120名患者，每组60名。两组在年龄、性别分布和结肠镜检查适应证方面相匹配。两组均未发生并发症。插管时间和结肠镜检查完成率未观察到显著差异。其他操作难易程度指标和疼痛评分也相似。然而，内镜医师报告称，在32%有阳性发现的检查中，MEI有助于定位结肠病变。
对于训练有素的内镜医师而言，该设备在改善操作性能方面并无益处。唯一确定的益处是定位病变。因此，虽然不建议常规使用MEI，但该设备可选择性地提供给局部治疗后进行随访检查的患者，或计划进行腹腔镜手术的小的结直肠肿瘤患者。
