Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama.
Division of Gastroenterology, National Center for Child Health and Development.
Eur J Gastroenterol Hepatol. 2019 Dec;31(12):1502-1507. doi: 10.1097/MEG.0000000000001513.
This multicenter, cross-sectional study aimed to elucidate the efficacy and safety of the AdvanCE capsule endoscope delivery device for children in Japan.
The present study analyzed 183 cases of small bowel capsule endoscope (SBCE) insertion performed using the AdvanCE in 154 patients aged less than 18 years at participating institutions between 2013 and 2017. Statistical analyses were conducted to identify factors contributing to the completion rate for the entire small intestine examination, small intestine transit time, adverse events and technical issues.
The commonest reason for using the AdvanCE was the patient's inability to swallow the SBCE, which was attributed to young age. SBCE was successfully delivered into the stomach or duodenum in 180 cases and was placed in the duodenum in 90% patients. In 89% patients, the entire small intestine was completely examined, and in 63% patients, findings leading to a new diagnosis or involving changing or maintaining the treatment strategy were obtained. No severe adverse events were observed; however, mild adverse events were observed in 35% patients. No factors considerably contributed to the completion rate for the entire small intestine examination or small intestine transit time and onset of technical issues. The factors that contributed to mild adverse events included intravenous anesthesia, technical issue, and absence of prior insertion of a patency capsule using the AdvanCE.
The AdvanCE is well tolerated and effective for children.
这项多中心、横断面研究旨在阐明 Advance 胶囊内镜输送装置在日本用于儿童的疗效和安全性。
本研究分析了 2013 年至 2017 年间，154 名年龄小于 18 岁的患者在参与机构中使用 Advance 进行的 183 例小肠胶囊内镜（SBCE）插入。进行了统计分析，以确定与整个小肠检查完成率、小肠通过时间、不良事件和技术问题相关的因素。
使用 Advance 的最常见原因是患者无法吞咽 SBCE，这归因于年龄较小。180 例 SBCE 成功输送到胃或十二指肠，90%的患者将 SBCE 放置在十二指肠。89%的患者对整个小肠进行了完全检查，63%的患者获得了新的诊断结果或涉及改变或维持治疗策略的发现。未观察到严重不良事件；然而，35%的患者出现轻微不良事件。没有因素对整个小肠检查或小肠通过时间和技术问题的发生有显著影响。导致轻微不良事件的因素包括静脉麻醉、技术问题以及未使用 Advance 插入通畅胶囊。
Advance 对儿童耐受良好且有效。
