Detachable string magnetically controlled capsule endoscopy for complete viewing of the esophagus and stomach
submitted 07. September 2018
accepted after revision 28. Januar 2019
01. März 2019 (online)
Background Esophageal capsule endoscopy is reported to be insufficiently accurate to replace esophagogastroduodenoscopy (EGD) because the passage of the capsule through the esophagus is passive and precludes a thorough investigation. We developed a modified capsule endoscopy technique, called detachable string magnetically controlled capsule endoscopy (DS-MCE), and performed a pilot study to assess the feasibility and safety of this novel technique.
Methods 4 healthy volunteers and 21 patients with suspected esophageal disease first underwent DS-MCE followed by EGD within 1 week. Outcomes included technical success of DS-MCE, adverse events, discomfort, and diagnostic accuracy.
Results DS-MCE was successfully carried out in all 25 participants. No adverse events were observed. Mean overall discomfort score during DS-MCE was 0.96 (range 0 – 3). DS-MCE diagnoses were in accordance with EGD in all 25 participants. The per-patient sensitivity of DS-MCE for esophageal disease detection was 100 %. The accuracy of DS-MCE for grading esophageal varices and reflux esophagitis were 66.7 % and 100 %, respectively.
Conclusions DS-MCE was a feasible, safe, and well-tolerated method for viewing the esophagus and proceeding with gastric examination after string detachment.
* These authors contributed equally to this work.
- 1 McCarty TR, Afinogenova Y, Njei B. Use of wireless capsule endoscopy for the diagnosis and grading of esophageal varices in patients with portal hypertension: a systematic review and meta-Analysis. J Clin Gastroenterol 2017; 51: 174-182
- 2 Hosoe N, Naganuma M, Ogata H. Current status of capsule endoscopy through a whole digestive tract. Dig Endosc 2015; 27: 205-215
- 3 Ramirez FC, Shaukat MS, Young MA. et al. Feasibility and safety of string, wireless capsule endoscopy in the diagnosis of Barrett’s esophagus. Gastrointest Endosc 2005; 61: 741-746
- 4 Liao Z, Gao R, Xu C. et al. Sleeve string capsule endoscopy for real-time viewing of the esophagus: a pilot study (with video). Gastrointest Endosc 2009; 70: 201-209
- 5 Liao Z, Hou X, Lin-Hu EQ. et al. Accuracy of magnetically controlled capsule endoscopy, compared with conventional gastroscopy, in detection of gastric diseases. Clin Gastroenterol Hepatol 2016; 14: 1266-1273
- 6 Zou WB, Hou XH, Xin L. et al. Magnetic-controlled capsule endoscopy vs. gastroscopy for gastric diseases: a two-center self-controlled comparative trial. Endoscopy 2015; 47: 525-528
- 7 Armstrong D, Bennett JR, Blum AL. et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology 1996; 111: 85-92
- 8 de Franchis R. Updating consensus in portal hypertension: report of the Baveno III Consensus Workshop on definitions, methodology and therapeutic strategies in portal hypertension. J Hepatol 2000; 33: 846-852
- 9 de Franchis R, Eisen GM, Laine L. et al. Esophageal capsule endoscopy for screening and surveillance of esophageal varices in patients with portal hypertension. Hepatology 2008; 47: 1595-1603
- 10 Chen WS, Zhu LH, Li DZ. et al. String esophageal capsule endoscopy with real-time viewing improves visualization of the distal esophageal Z-line: a prospective, comparative study. Eur J Gastroenterol Hepatol 2014; 26: 309-312
- 11 Tziatzios G, Gkolfakis P, Dimitriadis GD. et al. Long-term effects of video capsule endoscopy in the management of obscure gastrointestinal bleeding. Ann Transl Med 2017; 5: 196
- 12 Ching HL, Hale MF, Kurien M. et al. Diagnostic yield of magnetically assisted capsule endoscopy versus gastroscopy in recurrent and refractory iron deficiency anemia. Endoscopy 2018; DOI: 10.1055/a-0750-5682.
- 13 Jiang X, Qian YY, Liu X. et al. Impact of magnetic steering on gastric transit time of a capsule endoscopy (with video). Gastrointest Endosc 2018; 88: 746-754