Academic Department of Gastroenterology and Hepatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, United Kingdom.
World J Gastroenterol. 2018 Jul 14;24(26):2893-2901. doi: 10.3748/wjg.v24.i26.2893.
To test the feasibility and performance of a novel upper gastrointestinal (GI) capsule endoscope using a nurse-led protocol.
We conducted a prospective cohort analysis of patients who declined gastroscopy (oesophagogastroduodenoscopy, OGD) but who consented to upper GI capsule endoscopy. Patients swallowed the upper GI capsule following ingestion of 1 liter of water (containing simethicone). A series of positional changes were used to exploit the effects of water flow and move the upper GI capsule from one gravity-dependent area to another using a nurse-led protocol. Capsule transit time, video reading time, mucosal visualisation, pathology detection and patient tolerance was evaluated.
Fifty patients were included in the study. The mean capsule transit times in the oesophagus and stomach were 28 s and 68 min respectively. Visualisation of the following major anatomical landmarks was achieved (graded 1-5: Poor to excellent): Oesophagus, 4.8 (± 0.5); gastro-oesophageal junction (GOJ), 4.8 (± 0.8); cardia, 4.8 (± 0.8); fundus, 3.8 (± 1.2); body, 4.5 (± 1); antrum, 4.5 (± 1); pylorus, 4.7 (± 0.8); duodenal bulb, 4.7 (± 0.7); second part of the duodenum (D2), 4.7 (± 1). The upper GI capsule reached D2 in 64% of patients. The mean video reading time was 48 min with standard playback mode and 20 min using Quickview ( = 0.0001). No pathology was missed using Quickview. Procedural tolerance was excellent. No complications were seen with the upper GI capsule.
The upper GI capsule achieved excellent views of the upper GI tract. Future studies should compare the diagnostic accuracy between upper GI capsule and OGD.
测试一种新型上消化道（GI）胶囊内镜使用护士主导方案的可行性和性能。
我们对拒绝接受胃镜检查（食管胃十二指肠镜检查，OGD）但同意接受上消化道胶囊内镜检查的患者进行了前瞻性队列分析。患者在吞下 1 升水（含二甲硅油）后吞下上消化道胶囊。使用一系列体位变化，利用水流的作用，通过护士主导的方案将上消化道胶囊从一个重力依赖区移动到另一个区。评估胶囊通过时间、视频读取时间、黏膜可视化、病理检测和患者耐受性。
本研究共纳入 50 例患者。食管和胃的平均胶囊通过时间分别为 28 秒和 68 分钟。以下主要解剖标志的可视化（评分 1-5：差至优）如下：食管，4.8（±0.5）；胃食管交界处（GOJ），4.8（±0.8）；贲门，4.8（±0.8）；胃底，3.8（±1.2）；体部，4.5（±1）；胃窦，4.5（±1）；幽门，4.7（±0.8）；十二指肠球部，4.7（±0.7）；十二指肠第二部（D2），4.7（±1）。上消化道胶囊在 64%的患者中到达 D2。标准播放模式下的平均视频读取时间为 48 分钟，使用 Quickview 为 20 分钟（ = 0.0001）。使用 Quickview 未遗漏任何病理。操作耐受性极好。上消化道胶囊无并发症。
上消化道胶囊对上消化道获得了极好的观察效果。未来的研究应比较上消化道胶囊和 OGD 的诊断准确性。
