Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
J Gastroenterol Hepatol. 2011 Aug;26(8):1270-4. doi: 10.1111/j.1440-1746.2011.06734.x.
The clinical utility of capsule endoscopy (CE) is often limited by incomplete small-bowel transit. The aim was to determine whether the use of an external real-time viewer could reduce delays caused by delayed gastric emptying of the capsule or delayed intestinal transit and also improve the rate of positive findings.
We compared the proportion of completed exams and positive results among a group of patients studied before introduction of real-time viewer and a group in which capsule transit through the esophagus, stomach, and small bowel was regularly monitored and actions (e.g. administration of water or intravenous metoclopramide) were taken if it was delayed.
One hundred procedures in the viewer group and 100 control procedures in the age-matched controls were analyzed. In the viewer group, additional water intake (22 cases) and/or administration of metoclopramide (26 cases) were required. Endoscopic-assisted duodenal placement of the capsule was required in three cases. Overall one-third (n=33) of cases required viewer-prompted interventions. The completion rate (86% vs 66%, P=0.002) and the rate of positive findings (80% vs 67%, P=0.04) were significantly higher in the viewer group compared to the no viewer group.
Checking the progress of the capsule with the external real-time viewer improved the diagnostic yield and completion rate of CE.
胶囊内镜（CE）的临床实用性常受到小肠转运不完全的限制。本研究旨在确定使用外部实时观察仪是否可以减少因胶囊胃排空延迟或肠转运延迟而导致的延迟，并提高阳性发现率。
我们比较了一组在引入实时观察仪之前接受检查的患者和一组定期监测胶囊通过食管、胃和小肠的传输并在延迟时采取行动（如给予水或静脉注射甲氧氯普胺）的患者中完成检查和阳性结果的比例。
在观察仪组中进行了 100 例检查，在年龄匹配的对照组中进行了 100 例对照检查。在观察仪组中，需要额外饮水（22 例）和/或给予甲氧氯普胺（26 例）。需要在内镜下辅助将胶囊放置在十二指肠中 3 例。总体而言，三分之一（n=33）的病例需要观察仪提示的干预。与无观察仪组相比，观察仪组的完成率（86% vs 66%，P=0.002）和阳性发现率（80% vs 67%，P=0.04）显著更高。
使用外部实时观察仪检查胶囊的进展情况可提高 CE 的诊断效果和完成率。
