Magnetically controlled capsule endoscopy in one-time gastro-small intestinal joint examination: a two-centre experience

Ya-Wei Liu, Yuan-Chen Wang, Jia-Hui Zhu, Xi Jiang, Wei Zhou, Jie Zhang, Zhuan Liao, En-Qiang Linghu, Ya-Wei Liu, Yuan-Chen Wang, Jia-Hui Zhu, Xi Jiang, Wei Zhou, Jie Zhang, Zhuan Liao, En-Qiang Linghu

Abstract

Background: The lesions of certain diseases are widely distributed in both stomach and small intestine, while the step-by-step strategy of gastroscopy followed by enteroscopy can be burdensome and costly. We aimed to determine if magnetically controlled capsule endoscopy (MCE) could be used in one-time gastro-small intestine (GSI) joint examination.

Methods: In this study, data of patients in Chinese PLA General Hospital and Changhai Hospital who underwent MCE GSI examination from January 2020 to August 2021 were retrospectively analysed. The primary outcome of this study was the success rate of one-time GSI joint examination, and secondary outcomes included visualization and cleanliness of gastrointestinal tract, gastrointestinal transit times, diagnostic yield and safety of MCE examination.

Results: A total of 768 patients were included. The success rate of one-time GSI joint examination was 92.58%. There were 94.92% MCEs observed > 90% gastric mucosa in the 6 anatomic landmarks. The rate of complete small bowel examination was 97.40%. The median gastric examination time, gastric transit time and small intestine transit time were 8.18 min, 63.89 min and 4.89 h, respectively. Magnetic steering of MCE significantly decreased gastric transit time (8.92 min vs. 79.68 min, P = 0.001) and increased duodenal lesion detection rate (13.47% vs. 6.26%, P = 0.001) when compared with non-magnetic steering group. Two capsules were retained and were removed by enteroscopy or spontaneously excreted.

Conclusions: MCE is feasible to complete GSI joint examination and the detection of both gastric and small intestinal diseases can be achieved simultaneously. Trial registration Clinical Trial Registration ClinicalTrials.gov, ID: NCT05069233.

Keywords: Gastric; Joint examination; Magnetically controlled capsule endoscopy; Small intestine.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Positive lesions detected by MCE. a Oesophagus cancer. b Oesophagus ulcer. c Oesophagitis. d Gastric cancer. e Gastric ulcer. f Gastric polyp. g Duodenum ulcer. h Duodenitis. i Small intestine ulcer. j Parasite. k Small intestine polyp. l Small enteritis

References

    1. Eliakim R. Video capsule endoscopy of the small bowel. Curr Opin Gastroenterol. 2013;29(2):133–139. doi: 10.1097/MOG.0b013e32835bdc03.
    1. Chen YZ, Pan J, Luo YY, Jiang X, Zou WB, Qian YY, Zhou W, Liu X, Li ZS, Liao Z. Detachable string magnetically controlled capsule endoscopy for complete viewing of the esophagus and stomach. Endoscopy. 2019;51(4):360–364. doi: 10.1055/a-0856-6845.
    1. Enns RA, Hookey L, Armstrong D, Bernstein CN, Heitman SJ, Teshima C, Leontiadis GI, Tse F, Sadowski D. Clinical practice guidelines for the use of video capsule endoscopy. Gastroenterology. 2017;152(3):497–514. doi: 10.1053/j.gastro.2016.12.032.
    1. Carpi F, Galbiati S, Carpi A. Magnetic shells for gastrointestinal endoscopic capsules as a means to control their motion. Biomed Pharmacother. 2006;60(8):370–374. doi: 10.1016/j.biopha.2006.07.001.
    1. Liao Z, Duan XD, Xin L, Bo LM, Wang XH, Xiao GH, Hu LH, Zhuang SL, Li ZS. Feasibility and safety of magnetic-controlled capsule endoscopy system in examination of human stomach: a pilot study in healthy volunteers. J Interv Gastroenterol. 2012;2(4):155–160. doi: 10.4161/jig.23751.
    1. Liao Z, Hou X, Lin-Hu EQ, Sheng JQ, Ge ZZ, Jiang B, Hou XH, Liu JY, Li Z, Huang QY, et al. Accuracy of magnetically controlled capsule endoscopy, compared with conventional gastroscopy, in detection of gastric diseases. Clin Gastroenterol Hepatol. 2016;14(9):1266–1273.e1261. doi: 10.1016/j.cgh.2016.05.013.
    1. Jiang X, Qian YY, Liu X, Pan J, Zou WB, Zhou W, Luo YY, Chen YZ, Li ZS, Liao Z. Impact of magnetic steering on gastric transit time of a capsule endoscopy (with video) Gastrointest Endosc. 2018;88(4):746–754. doi: 10.1016/j.gie.2018.06.031.
    1. Gerson LB, Fidler JL, Cave DR, Leighton JA. ACG Clinical Guideline: diagnosis and management of small bowel bleeding. Am J Gastroenterol. 2015;110(9):1265–1287. doi: 10.1038/ajg.2015.246.
    1. Lanas Á, Carrera-Lasfuentes P, Arguedas Y, García S, Bujanda L, Calvet X, Ponce J, Perez-Aísa Á, Castro M, Muñoz M, et al. Risk of upper and lower gastrointestinal bleeding in patients taking nonsteroidal anti-inflammatory drugs, antiplatelet agents, or anticoagulants. Clin Gastroenterol Hepatol. 2015;13(5):906–912.e902. doi: 10.1016/j.cgh.2014.11.007.
    1. Otani I, Oka S, Tanaka S, Tsuboi A, Kunihara S, Nagaoki Y, Aikata H, Chayama K. Clinical significance of small-bowel villous edema in patients with liver cirrhosis: a capsule endoscopy study. J Gastroenterol Hepatol. 2018;33(4):825–830. doi: 10.1111/jgh.14016.
    1. Tang SJ, Christodoulou D, Zanati S, Dubcenco E, Petroniene R, Cirocco M, Kandel G, Haber GB, Kortan P, Marcon NE. Wireless capsule endoscopy for obscure gastrointestinal bleeding: a single-centre, one-year experience. Can J Gastroenterol. 2004;18(9):559–565. doi: 10.1155/2004/205685.
    1. Luo YY, Pan J, Chen YZ, Jiang X, Zou WB, Qian YY, Zhou W, Liu X, Li ZS, Liao Z. Magnetic steering of capsule endoscopy improves small bowel capsule endoscopy completion rate. Dig Dis Sci. 2019;64(7):1908–1915. doi: 10.1007/s10620-019-5479-z.
    1. Cave DR, Hakimian S, Patel K. Current controversies concerning capsule endoscopy. Dig Dis Sci. 2019;64(11):3040–3047. doi: 10.1007/s10620-019-05791-4.
    1. Westerhof J, Weersma RK, Koornstra JJ. Risk factors for incomplete small-bowel capsule endoscopy. Gastrointest Endosc. 2009;69(1):74–80. doi: 10.1016/j.gie.2008.04.034.
    1. Ching H-L, Hale MF, McAlindon ME. Current and future role of magnetically assisted gastric capsule endoscopy in the upper gastrointestinal tract. Ther Adv Gastroenterol. 2016;9(3):313–321. doi: 10.1177/1756283X16633052.
    1. Jiang X, Pan J, Li ZS, Liao Z. Standardized examination procedure of magnetically controlled capsule endoscopy. VideoGIE Off Video J Am Soc Gastrointest Endosc. 2019;4(6):239–243.
    1. Ching HL, Hale MF, Kurien M, Campbell JA, Chetcuti Zammit S, Healy A, Thurston V, Hebden JM, Sidhu R, McAlindon ME. Diagnostic yield of magnetically assisted capsule endoscopy versus gastroscopy in recurrent and refractory iron deficiency anemia. Endoscopy. 2019;51(5):409–418. doi: 10.1055/a-0750-5682.
    1. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–1457. doi: 10.1016/S0140-6736(07)61602-X.
    1. Jiang B, Qian YY, Pan J, Jiang X, Wang YC, Zhu JH, Zou WB, Zhou W, Li ZS, Liao Z. Second-generation magnetically controlled capsule gastroscopy with improved image resolution and frame rate: a randomized controlled clinical trial (with video) Gastrointest Endosc. 2020;91(6):1379–1387. doi: 10.1016/j.gie.2020.01.027.
    1. Wang YC, Pan J, Jiang X, Su XJ, Zhou W, Zou WB, Qian YY, Chen YZ, Liu X, Yu J, et al. Repetitive position change improves gastric cleanliness for magnetically controlled capsule gastroscopy. Dig Dis Sci. 2019;64(5):1297–1304. doi: 10.1007/s10620-018-5415-7.
    1. Zhu SG, Qian YY, Tang XY, Zhu QQ, Zhou W, Du H, An W, Su XJ, Zhao AJ, Ching HL, et al. Gastric preparation for magnetically controlled capsule endoscopy: a prospective, randomized single-blinded controlled trial. Dig Liver Dis. 2018;50(1):42–47. doi: 10.1016/j.dld.2017.09.129.
    1. Dai N, Gubler C, Hengstler P, Meyenberger C, Bauerfeind P. Improved capsule endoscopy after bowel preparation. Gastrointest Endosc. 2005;61(1):28–31. doi: 10.1016/S0016-5107(04)02444-7.
    1. Chen WS, Zhu LH, Li DZ, Chen L, Wu YL, Wang W. 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(3):309–312. doi: 10.1097/MEG.0000000000000038.
    1. Hookey L, Louw J, Wiepjes M, Rubinger N, Van Weyenberg S, Day AG, Paterson W. Lack of benefit of active preparation compared with a clear fluid-only diet in small-bowel visualization for video capsule endoscopy: results of a randomized, blinded, controlled trial. Gastrointest Endosc. 2017;85(1):187–193. doi: 10.1016/j.gie.2016.07.028.
    1. Gralnek IM, Adler SN, Yassin K, Koslowsky B, Metzger Y, Eliakim R. Detecting esophageal disease with second-generation capsule endoscopy: initial evaluation of the PillCam ESO 2. Endoscopy. 2008;40(4):275–279. doi: 10.1055/s-2007-995645.
    1. Neale JR, James S, Callaghan J, Patel P. Premedication with N-acetylcysteine and simethicone improves mucosal visualization during gastroscopy: a randomized, controlled, endoscopist-blinded study. Eur J Gastroenterol Hepatol. 2013;25(7):778–783. doi: 10.1097/MEG.0b013e32836076b2.
    1. Rey JF, Repici A, Kuznetsov K, Boyko V, Aabakken L. Optimal preparation for small bowel examinations with video capsule endoscopy. Dig Liver Dis. 2009;41(7):486–493. doi: 10.1016/j.dld.2008.09.016.
    1. Dupont WD, Plummer WD., Jr Power and sample size calculations: a review and computer program. Control Clin Trials. 1990;11(2):116–128. doi: 10.1016/0197-2456(90)90005-M.
    1. Rahman I, Afzal NA, Patel P. The role of magnetic assisted capsule endoscopy (MACE) to aid visualisation in the upper GI tract. Comput Biol Med. 2015;65:359–363. doi: 10.1016/j.compbiomed.2015.03.014.
    1. Ching HL, Healy A, Thurston V, Hale MF, Sidhu R, McAlindon ME. Upper gastrointestinal tract capsule endoscopy using a nurse-led protocol: First reported experience. World J Gastroenterol. 2018;24(26):2893–2901. doi: 10.3748/wjg.v24.i26.2893.
    1. Rahman I, Pioche M, Shim CS, Lee SP, Sung IK, Saurin JC, Patel P. Magnetic-assisted capsule endoscopy in the upper GI tract by using a novel navigation system (with video) Gastrointest Endosc. 2016;83(5):889–895.e881. doi: 10.1016/j.gie.2015.09.015.
    1. Lien GS, Wu MS, Chen CN, Liu CW, Suk FM. Feasibility and safety of a novel magnetic-assisted capsule endoscope system in a preliminary examination for upper gastrointestinal tract. Surg Endosc. 2018;32(4):1937–1944. doi: 10.1007/s00464-017-5887-0.
    1. Fernandez-Urien I, Carretero C, Borobio E, Borda A, Estevez E, Galter S, Gonzalez-Suarez B, Gonzalez B, Lujan M, Martinez JL, et al. Capsule endoscopy capture rate: has 4 frames-per-second any impact over 2 frames-per-second? World J Gastroenterol. 2014;20(39):14472–14478. doi: 10.3748/wjg.v20.i39.14472.
    1. Ramirez FC, Hakim S, Tharalson EM, Shaukat MS, Akins R. Feasibility and safety of string wireless capsule endoscopy in the diagnosis of esophageal varices. Am J Gastroenterol. 2005;100(5):1065–1071. doi: 10.1111/j.1572-0241.2005.41037.x.
    1. Liao Z, Gao R, Xu C, Xu DF, Li ZS. Sleeve string capsule endoscopy for real-time viewing of the esophagus: a pilot study (with video) Gastrointest Endosc. 2009;70(2):201–209. doi: 10.1016/j.gie.2008.10.043.
    1. Bartzis L, Koulaouzidis A. String-mounted double-headed capsule and Z-line detection: is string really the thing? Eur J Gastroenterol Hepatol. 2014;26(6):685–686. doi: 10.1097/MEG.0000000000000090.
    1. Song T, Ma J, Guo L, Yang P, Zhou X, Ye T. Regulation of chondrocyte functions by transient receptor potential cation channel V6 in osteoarthritis. J Cell Physiol. 2017;232(11):3170–3181. doi: 10.1002/jcp.25770.
    1. Wang S, Huang Y, Hu W, Mao H, McAlindon ME, Liu Y, Yang L, Zhang C, Xu M, He C, et al. Detachable string magnetically controlled capsule endoscopy for detecting high-risk varices in compensated advanced chronic liver disease (CHESS1801): a prospective multicenter study. Lancet Reg Health Western Pac. 2021;6:100072. doi: 10.1016/j.lanwpc.2020.100072.
    1. Wang YC, Pan J, Liu YW, Sun FY, Qian YY, Jiang X, Zou WB, Xia J, Jiang B, Ru N, et al. Adverse events of video capsule endoscopy over the past two decades: a systematic review and proportion meta-analysis. BMC Gastroenterol. 2020;20(1):364. doi: 10.1186/s12876-020-01491-w.
    1. Ou G, Shahidi N, Galorport C, Takach O, Lee T, Enns R. Effect of longer battery life on small bowel capsule endoscopy. World J Gastroenterol. 2015;21(9):2677–2682. doi: 10.3748/wjg.v21.i9.2677.
    1. Wei W, Ge ZZ, Lu H, Gao YJ, Hu YB, Xiao SD. Effect of mosapride on gastrointestinal transit time and diagnostic yield of capsule endoscopy. J Gastroenterol Hepatol. 2007;22(10):1605–1608. doi: 10.1111/j.1440-1746.2007.05064.x.
    1. Gao YJ, Ge ZZ, Chen HY, Li XB, Dai J, Ye CA, Xiao SD. Endoscopic capsule placement improves the completion rate of small-bowel capsule endoscopy and increases diagnostic yield. Gastrointest Endosc. 2010;72(1):103–108. doi: 10.1016/j.gie.2009.12.003.

Source: PubMed

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