Wang Yuan-Chen, Pan Jun, Liu Ya-Wei, Sun Feng-Yuan, Qian Yang-Yang, Jiang Xi, Zou Wen-Bin, Xia Ji, Jiang Bin, Ru Nan, Zhu Jia-Hui, Linghu En-Qiang, Li Zhao-Shen, Liao Zhuan
National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai, 200433, China.
Department of Gastroenterology, The First Medical Center of PLA General Hospital/Chinese PLA Postgraduate Military Medical School, 28 Fuxing Road, Beijing, 100853, China.
BMC Gastroenterol. 2020 Nov 2;20(1):364. doi: 10.1186/s12876-020-01491-w.
A full spectrum of video capsule endoscopy (VCE) adverse events over the past two decades has not been evaluated. We aimed to determine pooled rates, predictors and temporal-trend of VCE adverse events over the past two decades.
Systematic search of PubMed and EMBASE for English-language publications reporting VCE adverse events (January 1, 2000 to March 31, 2019). Data were extracted independently by two investigators. Pooled VCE adverse event rates were calculated using the random or fixed model as appropriate. Predictors and temporal-trend of each adverse event were performed by meta-regression analyses.
In total, 402 studies were identified, including 108,079 VCE procedures. Rate of retention, swallow disorder, aspiration, technical failure, and procedural adverse events were 0.73% (95% confidence interval [CI] 0.59-0.89%), 0.75% (95% CI 0.43-1.13%), 0.00% (95% CI 0.00-0.00%), 0.94% (95% CI 0.65-1.28%), 0.67% (95% CI 0.32-1.10%), respectively; incomplete examination rate of esophagus, stomach, small bowel, and colon were 9.05%, 7.69%, 12.08%, 19.19%, respectively. Patency capsule reduced retention rate by 5.04%, whereas known inflammatory bowel disease increased retention rate by 4.29%. Elder was the risk and protective factor for small bowel incomplete examination (0.30%) and swallow disorder (- 0.72%), respectively. Rates of retention and small bowel incomplete examination significantly declined over time (P = .0006 and P < .0001)..
VCE adverse event rates were generally low, and retention and small bowel incomplete examination rates declined over the past two decades. Patients with known inflammatory bowel disease or elder should be alerted to high risk of retention or small bowel incomplete examination (PROSPERO: CRD42019139595).
过去二十年中视频胶囊内镜检查（VCE）的全谱不良事件尚未得到评估。我们旨在确定过去二十年中VCE不良事件的合并发生率、预测因素和时间趋势。
系统检索PubMed和EMBASE中报告VCE不良事件的英文出版物（2000年1月1日至2019年3月31日）。由两名研究人员独立提取数据。根据情况使用随机或固定模型计算VCE不良事件合并发生率。通过Meta回归分析对每种不良事件的预测因素和时间趋势进行分析。
共纳入402项研究，包括108,079例VCE检查。滞留率、吞咽障碍率、误吸率、技术失败率和操作不良事件率分别为0.73%（95%置信区间[CI] 0.59 - 0.89%）、0.75%（95% CI 0.43 - 1.13%）、0.00%（95% CI 0.00 - 0.00%）、0.94%（95% CI 0.65 - 1.28%）、0.67%（95% CI 0.32 - 1.10%）；食管、胃、小肠和结肠的检查不完整率分别为9.05%、7.69%、12.08%、19.19%。通畅胶囊使滞留率降低了5.04%，而已知的炎症性肠病使滞留率增加了4.29%。年龄较大分别是小肠检查不完整（0.30%）和吞咽障碍（-0.72%）的危险因素和保护因素。滞留率和小肠检查不完整率随时间显著下降（P = 0.0006和P < 0.0001）。
VCE不良事件发生率总体较低，过去二十年中滞留率和小肠检查不完整率有所下降。对于已知患有炎症性肠病或年龄较大的患者，应警惕滞留或小肠检查不完整的高风险（国际前瞻性系统评价注册库：CRD42019139595）。
