Mitsui Keigo, Fujimori Shunji, Tanaka Shu, Ehara Akihito, Omori Jun, Akimoto Naohiko, Maki Kotaro, Suzuki Masahiro, Kosugi Yuki, Ensaka Yukiko, Matsuura Yoko, Kobayashi Tsuyoshi, Yonezawa Masaoki, Tatsuguchi Atsushi, Sakamoto Choitsu
Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan.
J Clin Gastroenterol. 2016 Feb;50(2):141-6. doi: 10.1097/MCG.0000000000000335.
The aim is to elucidate the efficacy and safety of double-balloon endoscopy (DBE) for small bowel capsule endoscopy (SBCE) retrieval from small bowel stricture and to follow the outcome of the stricture where the SBCE was entrapped.
The retention of SBCE is a serious adverse event and most retained capsules are retrieved by surgery. There is still no report analyzing the follow-up of patients with stricture after retrieval of entrapped SBCEs by DBE.
This study was designed a retrospective cohort study. Subjects were 12 consecutive patients with small bowel stricture where retrieval of entrapped SBCE was attempted using DBE. Success rate of the SBCE retrieval by DBE, surgical rate of the small bowel stricture, adverse events of DBE, and outcomes in the follow-up period were evaluated.
Diagnoses were Crohn's disease, nonsteroidal anti-inflammatory drugs-induced enteropathy, ischemic enteritis, and carcinoma in 8, 2, 1, and 1 patients, respectively. SBCE was successfully retrieved in 11 of the 12 patients (92%). No adverse events were encountered in all endoscopic procedures such as retrieval of SBCEs and dilation of the strictures. Nine of the 12 patients (75%) did not undergo surgical treatment for the stricture where SBCE was entrapped through the follow-up period (mean, 1675±847 d).
Retrieval of SBCEs using DBE was safe, had a high success rate, and was useful to evaluate the need for surgery. Seventy-five percent of patients with small bowel stricture where the SBCE was entrapped did not require surgery through approximately 5 years.
旨在阐明双气囊小肠镜(DBE)用于从小肠狭窄处取出小肠胶囊内镜(SBCE)的有效性和安全性,并追踪SBCE被困处狭窄的转归情况。
SBCE滞留是一种严重不良事件,大多数滞留的胶囊需通过手术取出。目前仍无关于DBE取出被困SBCE后狭窄患者随访情况分析的报道。
本研究设计为回顾性队列研究。研究对象为12例连续的小肠狭窄患者,尝试使用DBE取出被困的SBCE。评估DBE取出SBCE的成功率、小肠狭窄的手术率、DBE的不良事件以及随访期间的转归情况。
诊断分别为克罗恩病、非甾体类抗炎药所致肠病、缺血性肠炎和癌的患者分别有8例、2例、1例和1例。12例患者中有11例(92%)成功取出SBCE。在所有内镜操作(如取出SBCE和扩张狭窄)中均未发生不良事件。12例患者中有9例(75%)在随访期间(平均1675±847天)未因SBCE被困处的狭窄接受手术治疗。
使用DBE取出SBCE安全、成功率高,且有助于评估手术需求。约75%的SBCE被困的小肠狭窄患者在大约5年内无需手术。