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通畅胶囊和结肠胶囊内镜检查疑似胃肠道狭窄患者的可行性:一项前瞻性研究。

Feasibility of patency capsule and colon capsule endoscopy in patients with suspected gastrointestinal stenosis: a prospective study.

机构信息

Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.

出版信息

Nagoya J Med Sci. 2021 Aug;83(3):419-430. doi: 10.18999/nagjms.83.3.419.

Abstract

Patency capsule (PC) can evaluate the patency of gastrointestinal (GI) tract. We hypothesized preceding patient selection using PC would improve the successful rate of colon capsule endoscopy (CCE). Therefore, a prospective single-arm study using PC followed by CCE was conducted with a control group of CCE alone. Patients with suspected or known GI stenosis scheduled for CCE were enrolled. CCE was performed only when the PC was excreted out of the body within 33 hours of ingestion. Primary endpoint was the rate of observation of the entire GI tract within the duration of examination. The secondary endpoints were complications and CCE findings. Twenty-three patients (17 men) were enrolled. The mean age was 50.5±19.8 years. Suspected stenotic sites were 8, 5, and 10 in the small, large, and small and large bowel, respectively. Sixteen, 12, and 10 patients had abdominal pain, active inflammatory bowel disease, and history of surgery for suspected stenosis, respectively. Patency of GI tract was confirmed in 96% (22/23) of the patients by administered PC. Of the 22 patients who underwent CCE, the entire GI tract was observed in 86% (19/22). No complications were observed. The median transit times in the small bowel and colon were 99 (21-682) and 160 (5-328) minutes, respectively. CCE findings revealed ulcers, erosions, and diverticula in 5, 9, and 4 patients, respectively. In conclusion, CCE with PC might be a safer and useful modality to observe the large colon for patients with suspected GI stenosis.

摘要

胶囊通畅度检测(PC)可用于评估胃肠道(GI)通畅度。我们假设在进行结肠镜胶囊检查(CCE)之前使用 PC 进行患者选择,可以提高 CCE 的成功率。因此,我们进行了一项前瞻性单臂研究,在 CCE 前使用 PC 进行患者选择,并设置了单独 CCE 的对照组。纳入疑似或已知存在 GI 狭窄并计划进行 CCE 的患者。只有当 PC 在摄入后 33 小时内排出体外时,才进行 CCE。主要终点是在检查持续时间内观察整个 GI 道的比例。次要终点是并发症和 CCE 结果。共纳入 23 例(17 例男性)患者。平均年龄为 50.5±19.8 岁。疑似狭窄部位分别位于小肠 8 处、大肠 5 处和小肠和大肠各 1 处。16 例、12 例和 10 例患者分别有腹痛、活动性炎症性肠病和疑似狭窄手术史。通过给予 PC,96%(22/23)的患者确认了 GI 道通畅。22 例进行 CCE 的患者中,86%(19/22)观察到整个 GI 道。未观察到并发症。小肠和结肠的中位转运时间分别为 99(21-682)和 160(5-328)分钟。CCE 结果显示 5 例、9 例和 4 例患者分别有溃疡、糜烂和憩室。总之,对于疑似 GI 狭窄的患者,PC 联合 CCE 可能是一种更安全、更有用的观察大肠的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/8438001/b4d6b3fdcc6d/2186-3326-83-0419-g001.jpg

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