Marelli Laura, Jaboli Francesca Maria, Jackson Linda, Palmer Hansa, Erian Gamal, Hamilton Mark, Epstein Owen
Centre for Gastroenterology, Royal Free Hospital, London, UK.
Frontline Gastroenterol. 2013 Apr;4(2):96-101. doi: 10.1136/flgastro-2012-100251. Epub 2012 Dec 19.
ESO-2 video capsule endoscopy provides images of the oesophageal mucosa and continues to transmit gastric, and often small bowel images, for up to 30 min. This study compares ESO capsule endoscopy capsule oesophago-gastro-duodenoscopy (Cap-OGD) with conventional endoscopy (OGD).
50 outpatients with uncomplicated dyspepsia underwent Cap-OGD followed by OGD which was recorded on DVD. Cap-OGD and OGD were each reported independently by two gastroenterologists. A benchmark report was also produced by two gastroenterologists viewing both Cap-OGD and OGD on side-by-side monitors. Major findings included large hiatus hernia, Barrett's oesophagus, oesophagitis, erosive gastritis, tumour and ulceration. Minor findings included histologically-proven superficial gastritis, pouting gastric folds and fundic gland polyps. A questionnaire assessed the patient experience.
49 patients completed the study. In 61%, Cap-OGD transmitted in the duodenum. In the benchmark study, all the major OGD findings were observed on Cap-OGD. Cap-OGD revealed fewer minor findings. When reported independently, Cap-OGD and OGD reports indicated differences in interpretation most marked between the capsule readers with or without previous ESO-2 experience. Patients expressed a clear preference for Cap-OGD.
When compared side-by-side, all the major findings on OGD are seen on Cap-OGD while there is under-reporting of minor findings. Previous experience of ESO-2 capsule reporting improves reading accuracy and indicates the need for training. This pilot study provides a backdrop to explore the possible role of Cap-OGD, especially where patients are reluctant to undergo conventional OGD or where there is risk of prion contamination of the endoscope.
ESO - 2型视频胶囊内镜可提供食管黏膜图像，并持续传输胃及通常还有小肠的图像，长达30分钟。本研究比较了ESO胶囊内镜食管胃十二指肠镜检查（Cap - OGD）与传统内镜检查（OGD）。
50例无并发症的消化不良门诊患者先接受Cap - OGD检查，随后接受OGD检查，并记录在DVD上。Cap - OGD和OGD检查结果分别由两位胃肠病学家独立报告。两位胃肠病学家在并排的监视器上同时查看Cap - OGD和OGD检查结果后，还生成了一份基准报告。主要发现包括大型食管裂孔疝、巴雷特食管、食管炎、糜烂性胃炎、肿瘤和溃疡。次要发现包括组织学证实的浅表性胃炎、胃皱襞隆起和胃底腺息肉。通过问卷调查评估患者体验。
49例患者完成了研究。61%的患者中，Cap - OGD传输到了十二指肠。在基准研究中，可以在Cap - OGD上观察到所有OGD的主要发现。Cap - OGD发现的次要发现较少。当独立报告时，Cap - OGD和OGD报告显示，有无ESO - 2检查经验的胶囊内镜阅片者之间在解读上的差异最为明显。患者明确表示更喜欢Cap - OGD。
并排比较时，OGD的所有主要发现都能在Cap - OGD上看到，而次要发现的报告较少。既往有ESO - 2胶囊报告经验可提高阅片准确性，并表明需要进行培训。这项初步研究为探索Cap - OGD的可能作用提供了背景，特别是在患者不愿接受传统OGD检查或存在内镜朊病毒污染风险的情况下。
