Tsuboi Akiyoshi, Oka Shiro, Tanaka Shinji, Iio Sumio, Otani Ichiro, Kunihara Sayoko, Chayama Kazuaki
Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Japan.
Department of Endoscopy and Medicine, Hiroshima University Hospital, Japan.
Intern Med. 2019 May 15;58(10):1375-1381. doi: 10.2169/internalmedicine.2043-18. Epub 2019 Jan 10.
Objective The utility of capsule endoscopy (CE) findings in the route selection for double balloon endoscopy (DBE) has not been adequately discussed. The PillCam Progress Indicator in the RAPID 6.5 software program graphically demonstrates the progress of the capsule endoscope through the small-bowel. This study aimed to clarify the usefulness of the PillCam Progress Indicator in choosing the initial DBE route. Methods We retrospectively examined 50 consecutive patients with 50 target lesions detected on both CE and DBE at Hiroshima University Hospital from January 2011 to February 2018. In this study, we selected antegrade DBE on the basis of % Capsule Progress <50% as a clinical trial. The association between the PillCam Progress Indicator data and the DBE route to the target lesion was analyzed. Results The target lesion was reached via the initial DBE route in 96% (48/50) of cases. The cutoff values for selecting an antegrade route for DBE were 50% for % Capsule Progress and 42% for % SB Time. At the cutoff value, the sensitivity, specificity, and positive and negative predictive values for route selection were 100%, 91%, 93%, and 100% for % Capsule Progress and 96%, 91%, 93%, and 95% for % SB Time. Conclusion The PillCam Progress Indicator was useful for determining the appropriate initial DBE route.
目的 尚未充分讨论胶囊内镜（CE）检查结果在双气囊内镜（DBE）路径选择中的作用。RAPID 6.5软件程序中的PillCam进度指示器以图形方式展示了胶囊内镜在小肠中的行进过程。本研究旨在阐明PillCam进度指示器在选择初始DBE路径方面的有用性。方法 我们回顾性研究了2011年1月至2018年2月在广岛大学医院连续接受CE和DBE检查且发现50个目标病变的50例患者。在本研究中，我们将胶囊进度百分比<50%作为一项临床试验，选择顺行DBE。分析了PillCam进度指示器数据与通往目标病变的DBE路径之间的关联。结果 96%（48/50）的病例通过初始DBE路径到达了目标病变。选择DBE顺行路径的截断值，胶囊进度百分比为50%，小肠时间百分比为42%。在截断值时，胶囊进度百分比用于路径选择的敏感性、特异性、阳性预测值和阴性预测值分别为100%、91%、93%和100%，小肠时间百分比分别为96%、91%、93%和95%。结论 PillCam进度指示器有助于确定合适的初始DBE路径。
