Brown G, Fraser C, Schofield G, Taylor S, Bartram C, Phillips R, Saunders B
The Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow, United Kingdom.
Endoscopy. 2006 Apr;38(4):385-90. doi: 10.1055/s-2006-925028.
Video capsule endoscopy has shown promise for the surveillance of significant small-bowel polyps in patients with Peutz-Jeghers syndrome. In this study the yield of significant small-bowel polyps by capsule endoscopy was compared to the yield of these polyps by barium follow-through in adults with Peutz-Jeghers syndrome.
A total of 19 adults with Peutz-Jeghers syndrome who were undergoing surveillance underwent both capsule endoscopy and barium follow-through examinations, and the number of small-bowel polyps of at least 1 cm in diameter that were detected was recorded for each method. The two methods were assessed in terms of comfort and convenience for the patients and their preferred future surveillance method, using a questionnaire.
Capsule endoscopy detected a median of four significant small-bowel polyps while barium follow-through detected a median of one (P = 0.008). There was a trend towards more participants having at least one significant small-bowel polyp detected by capsule endoscopy than was the case with barium follow-through, though capsule endoscopy seemed to be less reliable for accurate sizing of polyps that were at the limit of clinical significance. Most participants expressed a preference for capsule endoscopy for future surveillance.
Capsule endoscopy should replace barium follow-through for the surveillance of small-bowel polyps in adults with Peutz-Jeghers syndrome, but the findings of this study should be interpreted with caution until a more reliable means of sizing polyps by capsule endoscopy is available.
视频胶囊内镜已显示出在监测黑斑息肉综合征患者的重要小肠息肉方面具有前景。在本研究中，将胶囊内镜检查发现重要小肠息肉的检出率与成人黑斑息肉综合征患者钡剂灌肠检查该类息肉的检出率进行了比较。
共有19名接受监测的黑斑息肉综合征成年患者同时接受了胶囊内镜检查和钡剂灌肠检查，并记录了每种检查方法检测到的直径至少为1厘米的小肠息肉数量。使用问卷调查评估这两种检查方法在患者舒适度和便利性方面以及他们未来首选的监测方法。
胶囊内镜检查发现的重要小肠息肉中位数为4个，而钡剂灌肠检查发现的中位数为1个（P = 0.008）。与钡剂灌肠检查相比，胶囊内镜检查似乎更倾向于能检测出至少一个重要小肠息肉的参与者更多，不过对于临床意义临界的息肉，胶囊内镜在准确测量大小方面似乎不太可靠。大多数参与者表示未来监测更倾向于选择胶囊内镜检查。
对于黑斑息肉综合征成年患者的小肠息肉监测，胶囊内镜应取代钡剂灌肠检查，但在有更可靠的胶囊内镜测量息肉大小的方法之前，本研究结果应谨慎解读。
