Department of Gastroenterology, The Alfred Hospital, Melbourne, Victoria, Australia.
Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Intern Med J. 2024 Aug;54(8):1369-1375. doi: 10.1111/imj.16385. Epub 2024 Apr 3.
Small bowel capsule endoscopy (SBCE) and device-assisted enteroscopy (DAE) have an established role in the investigation and management of small bowel pathology. Previous studies have reported on the yield of SBCE (60%) and DAE (57%), but none have been in an Australian setting.
To determine the yield of SBCE and any DAE performed as a direct consequence of SBCE in an Australian referral centre.
A single-centre retrospective study was conducted at a tertiary hospital in Australia, enrolling consecutive patients between 1 January 2009 and 31 December 2021 undergoing SBCE. Data were collected with respect to demographics, procedural factors and findings, as well as findings and interventions of any DAE procedures performed after the SBCE.
1214 SBCEs were performed, with a median age of 66 years old (60.8% men). The predominant indications were anaemia (n = 853, 70.2%) and overt gastrointestinal bleeding (n = 320, 26.4%). Of the complete small bowel studies (1132/1214, 93.2%), abnormal findings were detected in 588 cases (51.9%), most commonly angioectasias (266/588, 45.2%), erosions (106/588, 18.0%) and ulcers (97/588, 8.6%). 165 patients underwent a DAE (117 antegrade, 48 retrograde). Antegrade DAE had a higher yield than retrograde DAE (77.8% vs 54.2%; P = 0.002) and a higher rate of intervention (69.2% vs 37.5%; P < 0.001).
In this largest single-centre cohort of patients undergoing SBCE to date, there is a similar yield of abnormal findings compared to existing literature. DAE, especially with an antegrade approach, had high diagnostic and therapeutic yield when pursued after a positive SBCE study.
小肠胶囊内镜（SBCE）和设备辅助的小肠镜检查（DAE）在小肠病理学的检查和治疗中具有重要作用。先前的研究报告了 SBCE（60%）和 DAE（57%）的检出率，但都没有在澳大利亚的环境中进行过。
确定在澳大利亚转诊中心进行 SBCE 后的 SBCE 和任何直接进行的 DAE 的检出率。
对澳大利亚一家三级医院在 2009 年 1 月 1 日至 2021 年 12 月 31 日期间连续进行的 SBCE 的患者进行了单中心回顾性研究。收集了患者的人口统计学、程序因素和发现以及任何进行 SBCE 后的 DAE 程序的发现和干预措施的数据。
进行了 1214 例 SBCE，中位年龄为 66 岁（60.8%为男性）。主要的适应证是贫血（n = 853，70.2%）和显性胃肠道出血（n = 320，26.4%）。在 1214 例完整的小肠研究中（1132/1214，93.2%），588 例（51.9%）发现异常，最常见的是血管扩张（266/588，45.2%）、糜烂（106/588，18.0%）和溃疡（97/588，8.6%）。165 例患者进行了 DAE（117 例顺行，48 例逆行）。顺行 DAE 的检出率高于逆行 DAE（77.8%比 54.2%；P = 0.002），干预率也更高（69.2%比 37.5%；P < 0.001）。
在迄今为止最大的单中心 SBCE 患者队列中，与现有文献相比，异常发现的检出率相似。当在阳性 SBCE 研究后进行 DAE 时，尤其是采用顺行方法，具有较高的诊断和治疗检出率。
