Meta-analysis of capsule endoscopy in patients diagnosed or suspected with esophageal varices

Abstract

AIM:To review the literature on capsule endoscopy (CE) for detecting esophageal varices using conventional esophagogastroduodenoscopy (EGD) as the standard. METHODS:A strict literature search of studies comparing the yield of CE and EGD in patients diagnosed or suspected as having esophageal varices was conducted by both computer search and manual search. Data were extracted to estimate the pooled diagnostic sensitivity and specificity. RESULTS:There were seven studies appropriate for meta-analysis in our study, involving 446 patients. The pooled sensitivity and specificity of CE for detecting esophageal varices were 85.8% and 80.5%, respectively. In subgroup analysis, the pooled sensitivity and specificity were 82.7% and 54.8% in screened patients, and 87.3% and 84.7% in the screened/ patients under surveillance, respectively.CONCLUSION: CE appears to have acceptable sensitivity and specificity in detecting esophageal varices. However, data are insufficient to determine the accurate diagnostic value of CE in the screen/ surveillance of patients alone.

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

“…Also, as in the Choe et al [21] study, we found that concordance rates on grading esophageal varices were excellent at 95% (κ = 0.91). These results are better than those reported by using endoscopy capsule for detection of esophageal varices [7][8][9] . With regards to erosive esophagitis diagnosed at upper endoscopy, E.G.…”

“…Several studies have shown that ECE is safe and has an acceptable accuracy for the evaluation of esophageal varices and can be used as an alternative to EGD for the screening of portal hypertension, especially in patients unable or unwilling to undergo EGD [7,9] . Unsedated small-caliber transnasal esophagoscopy offers the possibility of efficient and accurate endoscopic assessment of the esophagus, with less cost and fewer risks compared with sedated upper endoscopy, and can be used as a method to screen for esophageal disease in a primary care population [11][12][13][14][15] .…”

“…Over the last years, several noninvasive or minimally invasive methods have been proposed as alternatives to conventional EGD for the diagnosis of esophageal diseases, such as esophageal capsule endoscopy (ECE) and ultra-thin small caliber esophagoscopes [7][8][9][10][11][12] . Several studies have shown that ECE is safe and has an acceptable accuracy for the evaluation of esophageal varices and can be used as an alternative to EGD for the screening of portal hypertension, especially in patients unable or unwilling to undergo EGD [7,9] .…”

Defining the Threshold: New Data on the Ability of Capsule Endoscopy to Discriminate the Size of Esophageal Varices

“…A meta-analysis of seven studies verified that CE has acceptable sensitivity and specificity (85.8% and 80.5%, respectively) in detecting esophageal varices [10,[14][15][16][17][18][19][20].…”

The Current Main Types of Capsule Endoscopy

“…A recent meta-analysis of seven studies involving 446 patients, ECE was found to have a sensitivity of 86 % and specificity 81 % in detecting esophageal varices (Fig. 2.12) [30].…”