Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Dig Endosc. 2013 Mar;25(2):156-9. doi: 10.1111/j.1443-1661.2012.01346.x. Epub 2012 Jul 2.
One of the prohibiting factors in achieving complete small bowel capsule endoscopy is slow gastric transit of the capsule. The present study retrospectively investigated the success rate of, and the time required for, transnasal endoscope-assisted capsule placement to assess its clinical utility.
In 24 of 27 patients who underwent capsule placement assisted by a transnasal endoscope, the capsule was successfully transported to and released in the duodenum (capsule placement group). For each patient in the capsule placement group, three age- and sex-matched patients who underwent conventional capsule endoscopy were assigned as controls (n=72). Gastric transit time, small bowel transit time, and rate of capsule arrival at the cecum within 8h were compared between the two patient groups.
Among the 27 patients in whom capsule placement was carried out, the capsule was successfully placed in the duodenum in 24 patients (88.9% success rate). In the capsule placement group, gastric transit time was significantly shorter (10.5 vs 46.2min, P=0.0021), small bowel transit time was significantly longer (354.7 vs 301.3min, P=0.0134), and completion rate (capsule arrival at the cecum within 8h) was significantly higher (83.3 vs 61.1%, P=0.0455) than in the control group. There were no procedural accidents associated with capsule placement.
Transnasal endoscope-assisted capsule placement appears to be a safe and reliable procedure, achieving complete small bowel capsule endoscopy, and is considered clinically useful.
胶囊内镜完整检查小肠的一个限制因素是胶囊在胃内转运缓慢。本研究回顾性调查经鼻内镜辅助胶囊放置的成功率和所需时间，以评估其临床应用价值。
在 27 例行经鼻内镜辅助胶囊放置的患者中，24 例胶囊成功转运并释放到十二指肠（胶囊放置组）。胶囊放置组中每例患者均匹配 3 例年龄和性别相同、行常规胶囊内镜检查的患者作为对照组（n=72）。比较两组患者的胃转运时间、小肠转运时间和 8 小时内胶囊到达盲肠的比例。
在 27 例实施胶囊放置的患者中，24 例（88.9%的成功率）胶囊成功放置在十二指肠内。在胶囊放置组中，胃转运时间明显缩短（10.5 分钟比 46.2 分钟，P=0.0021），小肠转运时间明显延长（354.7 分钟比 301.3 分钟，P=0.0134），完成率（8 小时内胶囊到达盲肠）明显更高（83.3%比 61.1%，P=0.0455）。胶囊放置过程中无操作相关并发症。
经鼻内镜辅助胶囊放置术安全可靠，可实现完整的小肠胶囊内镜检查，具有临床应用价值。
