Singeap Ana-Maria, Stanciu Carol, Trifan Anca
Ana-Maria Singeap, Anca Trifan, Gastroenterology and Hepatology Institute, "Gr. T. Popa" University of Medicine and Pharmacy, "St. Spiridon" Emergency Hospital, 700111 Iasi, Romania.
World J Gastroenterol. 2016 Jan 7;22(1):369-78. doi: 10.3748/wjg.v22.i1.369.
Since its introduction into clinical practice 15 years ago, capsule endoscopy (CE) has become the first-line investigation procedure in some small bowel pathologies, and more recently, dedicated esophageal and colon CE have expanded the fields of application to include the upper and lower gastrointestinal disorders. During this time, CE has become increasingly popular among gastroenterologists, with more than 2 million capsule examinations performed worldwide, and nearly 3000 PubMed-listed studies on its different aspects published. This huge interest in CE may be explained by its non-invasive nature, patient comfort, safety, and access to anatomical regions unattainable via conventional endoscopy. However, CE has several limitations which impede its wider clinical applications, including the lack of therapeutic capabilities, inability to obtain biopsies and control its locomotion. Several research groups are currently working to overcome these limitations, while novel devices able to control capsule movement, obtain high quality images, insufflate the gut lumen, perform chromoendoscopy, biopsy of suspect lesions, or even deliver targeted drugs directly to specific sites are under development. Overlooking current limitations, especially as some of them have already been successfully surmounted, and based on the tremendous progress in technology, it is expected that, by the end of next 15 years, CE able to perform both diagnostic and therapeutic procedures will remain the major form of digestive endoscopy. This review summarizes the literature that prognosticates about the future developments of CE.
自15年前引入临床实践以来,胶囊内镜(CE)已成为某些小肠疾病的一线检查方法,最近,专用的食管和结肠CE已将应用领域扩展到包括上、下胃肠道疾病。在此期间,CE在胃肠病学家中越来越受欢迎,全球进行了超过200万次胶囊检查,并且有近3000篇关于其不同方面的PubMed收录研究发表。对CE的这种巨大兴趣可能是由于其非侵入性、患者舒适度高、安全性好以及能够进入传统内镜无法到达的解剖区域。然而,CE有几个限制因素阻碍了其更广泛的临床应用,包括缺乏治疗能力、无法获取活检组织以及无法控制其移动。目前有几个研究小组正在努力克服这些限制,同时能够控制胶囊运动、获取高质量图像、向肠腔内注入气体、进行染色内镜检查、对可疑病变进行活检甚至直接将靶向药物输送到特定部位的新型设备正在开发中。忽略当前的限制,特别是其中一些已经成功克服,并且基于技术上的巨大进步,预计在未来15年末,能够执行诊断和治疗程序的CE仍将是消化内镜检查的主要形式。这篇综述总结了预测CE未来发展的文献。