Oesophageal capsule endoscopy versus oesophago-gastroduodenoscopy for the diagnosis of recurrent varices: A prospective multicentre study

Laurain, Anne; Leusse, A de; Gincul, Rodica; Vanbiervliet, Geoffroy; Bramli, Slim; Heyries, Laurent; Martane, Gabriel; Amrani, N.; Serraj, I.; Saurin, Jean‐Christophe; Borentain, Patrick; Filoche, B; Duburque, Clotilde; Gaudric, M; Sogni, Philippe; Dumortier, Jérôme

doi:10.1016/j.dld.2014.02.002

Cited by 13 publications

(8 citation statements)

References 42 publications

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“…The Pillcam ® ESO, capturing a total of fourteen frames (seven from each end) per second[ 27 ] was superseded by the ESO2[ 28 ], capturing a total of 18 frames per second. The 35 frames per second delivered by the UGI capsule would deliver almost 1000 oesophageal images in the average transit time of 28 s shown in our evaluation.…”

Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal tract capsule endoscopy using a nurse-led protocol: First reported experience

Ching

Healy

Thurston

et al. 2018

WJG

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AIMTo test the feasibility and performance of a novel upper gastrointestinal (GI) capsule endoscope using a nurse-led protocol.METHODSWe conducted a prospective cohort analysis of patients who declined gastroscopy (oesophagogastroduodenoscopy, OGD) but who consented to upper GI capsule endoscopy. Patients swallowed the upper GI capsule following ingestion of 1 liter of water (containing simethicone). A series of positional changes were used to exploit the effects of water flow and move the upper GI capsule from one gravity-dependent area to another using a nurse-led protocol. Capsule transit time, video reading time, mucosal visualisation, pathology detection and patient tolerance was evaluated.RESULTSFifty patients were included in the study. The mean capsule transit times in the oesophagus and stomach were 28 s and 68 min respectively. Visualisation of the following major anatomical landmarks was achieved (graded 1-5: Poor to excellent): Oesophagus, 4.8 (± 0.5); gastro-oesophageal junction (GOJ), 4.8 (± 0.8); cardia, 4.8 (± 0.8); fundus, 3.8 (± 1.2); body, 4.5 (± 1); antrum, 4.5 (± 1); pylorus, 4.7 (± 0.8); duodenal bulb, 4.7 (± 0.7); second part of the duodenum (D2), 4.7 (± 1). The upper GI capsule reached D2 in 64% of patients. The mean video reading time was 48 min with standard playback mode and 20 min using Quickview (P = 0.0001). No pathology was missed using Quickview. Procedural tolerance was excellent. No complications were seen with the upper GI capsule.CONCLUSIONThe upper GI capsule achieved excellent views of the upper GI tract. Future studies should compare the diagnostic accuracy between upper GI capsule and OGD.

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Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal tract capsule endoscopy using a nurse-led protocol: First reported experience

Ching

Healy

Thurston

et al. 2018

WJG

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“…50 patients were recruited into the study, of which 47 (94%) completed the MACE procedure and 50 (100%) completed the EGD. As per the recruitment criteria these were composed of patients with endoscopically diagnosed BE (17), EV (17) and patients with neither BE or EV (16). In those with EV endoscopy graded these as large in 100% of cases, whilst in those with BE the average Barrett's segment legnth was 3 cms (2-5), with 22 patients diagnosed with a hiatus hernia.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Diagnosis of Barrett’s esophagus and esophageal varices using a magnetically assisted capsule endoscopy system

Beg

Card

Warburton

et al. 2020

Gastrointestinal Endoscopy

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BackgroundMagnetically Assisted Capsule Endoscopy (MACE) potentially offers a comfortable, patient friendly and community-based alternative to gastroscopy (EGD). This pilot study aims to explore whether this approach can be used to accurately diagnose Barrett's oesophagus and esophageal varices. MethodsThe MiroCam Navi capsule system was used to examine the upper gastrointestinal tract in patients due to undergo a clinically indicated EGD. A total of 50 participants were enrolled, of which 34 had known pathology, 17 Barrett's Esophagus (BE), 17 Esophageal Varices (EV), with 16 controls. Patients underwent the MACE procedure, with the operator blinded to the indication and any previous endoscopic diagnoses. The subsequent EGD was performed by an endoscopist blinded to the MACE findings. Diagnostic yield, comfort and patient preference between the two modalities were compared. ResultsParticipants had a mean age of 61 years old, a M: F of 2.1:1, a mean BMI of 29.5, with an average chest measurement of 105.3cms. 47 patients undertook both procedures, 3 patients were unable to swallow the capsule. With the use of the magnet, it was possible to hold the capsule within the esophagus for a mean duration of 190 secs and up to a maximum of 634 secs. A correct real-time MACE diagnosis was made in 11/15 patients with EV (sensitivity 73.3% (44.9-92.2%) and specificity 100% (89.1-100%) and 15/16 patients with BE (sensitivity 93.8% (69.8-99.8%) and a specificity of 100% (88.8-100%). MACE was considered more comfortable than conventional endoscopy (p<0.0001) with a mean score of 9.2 with MACE compared to 6.7 with EGD, when assessed on a 10-point scale. No MACE or EGD related adverse events occurred. ConclusionThis pilot study demonstrates that MACE is both safe and well tolerated by patients. Accuracy for the diagnosis of BE was high and may therefore have a role in screening for this condition.

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“…Even though capsule endoscopy is relatively less invasive and does not require sedation, the diagnostic sensitivity is not adequate to advocate for index surveillance. It may be a consideration for a select subgroup of high-risk patients who are unwilling to undergo more invasive traditional endoscopic evaluation[43,44]. One study showed that 97% of the patients preferred capsule endoscopy over endoscopy with or without sedation[44].…”

Section: Diagnostic Tests For Gastrointestinal Varicesmentioning

confidence: 99%

Update on the management of gastrointestinal varices

Boregowda¹,

Umapathy²,

Halim³

et al. 2019

WJGPT

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Cirrhosis of liver is a major problem in the western world. Portal hypertension is a complication of cirrhosis and can lead to a myriad of pathology of which include the development of porto-systemic collaterals. Gastrointestinal varices are dilated submucosal veins, which often develop at sites near the formation of gastroesophageal collateral circulation. The incidence of varices is on the rise due to alcohol and obesity. The most significant complication of portal hypertension is life-threatening bleeding from gastrointestinal varices, which is associated with substantial morbidity and mortality. In addition, this can cause a significant burden on the health care facility. Gastrointestinal varices can happen in esophagus, stomach or ectopic varices. There has been considerable progress made in the understanding of the natural history, pathophysiology and etiology of portal hypertension. Despite the development of endoscopic and medical treatments, early mortality due to variceal bleeding remains high due to significant illness of the patient. Recurrent variceal bleed is common and in some cases, there is refractory variceal bleed. This article aims to provide a comprehensive review of the management of gastrointestinal varices with an emphasis on endoscopic interventions, strategies to handle refractory variceal bleed and newer endoscopic treatment modalities. Early treatment and improved endoscopic techniques can help in improving morbidity and mortality.

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Oesophageal capsule endoscopy versus oesophago-gastroduodenoscopy for the diagnosis of recurrent varices: A prospective multicentre study

Cited by 13 publications

References 42 publications

Upper gastrointestinal tract capsule endoscopy using a nurse-led protocol: First reported experience

Upper gastrointestinal tract capsule endoscopy using a nurse-led protocol: First reported experience

Diagnosis of Barrett’s esophagus and esophageal varices using a magnetically assisted capsule endoscopy system

Update on the management of gastrointestinal varices

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