Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães 4835-044, Portugal.
Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga 4710-057, Portugal.
World J Gastroenterol. 2024 Mar 14;30(10):1270-1279. doi: 10.3748/wjg.v30.i10.1270.
In 2000, the small bowel capsule revolutionized the management of patients with small bowel disorders. Currently, the technological development achieved by the new models of double-headed endoscopic capsules, as miniaturized devices to evaluate the small bowel and colon [pan-intestinal capsule endoscopy (PCE)], makes this non-invasive procedure a disruptive concept for the management of patients with digestive disorders. This technology is expected to identify which patients will require conventional invasive endoscopic procedures (colonoscopy or balloon-assisted enteroscopy), based on the lesions detected by the capsule, those with an indication for biopsies or endoscopic treatment. The use of PCE in patients with inflammatory bowel diseases, namely Crohn's disease, as well as in patients with iron deficiency anaemia and/or overt gastrointestinal (GI) bleeding, after a non-diagnostic upper endoscopy (esophagogastroduodenoscopy), enables an effective, safe and comfortable way to identify patients with relevant lesions, who should undergo subsequent invasive endoscopic procedures. The recent development of magnetically controlled capsule endoscopy to evaluate the upper GI tract, is a further step towards the possibility of an entirely non-invasive assessment of all the segments of the digestive tract, from mouth-to-anus, meeting the expectations of the early developers of capsule endoscopy.
2000 年,小肠胶囊彻底改变了小肠疾病患者的治疗方式。目前,双探头内镜胶囊等新型设备的技术发展,使小肠和结肠的评估(全肠道胶囊内镜检查,PCE)微型化,这一非侵入性程序为治疗消化道疾病的患者提供了一种颠覆性的理念。这项技术有望根据胶囊检测到的病变,确定哪些患者需要进行传统的有创内镜检查(结肠镜或气囊辅助式小肠镜检查),并明确哪些患者需要进行活检或内镜治疗。在克罗恩病等炎症性肠病患者、以及在上消化道内镜检查(食管胃十二指肠镜检查)无明确诊断结果但有缺铁性贫血和/或显性胃肠道出血的患者中使用 PCE,可以有效、安全、舒适地识别出有相关病变的患者,这些患者应进行后续的有创内镜检查。目前,磁控胶囊内镜在评估上消化道方面的新发展,是实现从口到肛门对整个消化道进行完全非侵入性评估的又一步,满足了胶囊内镜早期开发者的期望。