The yield and safety of string capsule endoscopy in patients with dysphagia - 22/08/11
Reprint requests: Francisco C. Ramirez, MD, Gastroenterology Section (111G), Carl T. Hayden VAMC, 650 E Indian School Rd, Phoenix, AZ 85012.Phoenix, Arizona, USA
Abstract |
Background |
Dysphagia is a contraindication for the use of conventional capsule endoscopy (CE). Because string CE (SCE) allows for the immediate retrieval of the device, it eliminates the risk of capsule retention.
Objective |
To assess the yield and safety of SCE in patients with dysphagia.
Design |
Comparative study of SCE and EGD.
Setting |
Phoenix Veteran Affairs Medical Center.
Patients and Interventions |
Patients with dysphagia underwent SCE and EGD.
Results |
In 40 patients with dysphagia, the EGD findings were normal in 13 (32.5%); Schatzki’s ring in 10 (25%); esophageal tumors in 9 (22.5%), with 1 of these having 2 separate and distinct malignancies; erosive esophagitis in 4 (10%); strictures in 2 (5%); and a web and large esophageal varices in 1 patient each (2.5%). The sensitivity of SCE for diagnosing anatomic pathology as the likely cause of dysphagia was 92.9%, with a specificity of 92.3%, a positive predictive value of 96.3%, and negative predictive value of 85.7%. The overall agreement between SCE and EGD was 92.7% and the kappa index was 0.83. There were no complications with either procedure. There was no case of capsule retention. The SCE recording time was 385.8 seconds; 77.5% patients preferred SCE to EGD.
Conclusions |
(1) SCE was safe, well tolerated, and accurate for the diagnosis of pathology responsible for dysphagia; (2) SCE was preferred to EGD by more than three fourths of patients; (3) SCE can be safely performed in patients with dysphagia.
Le texte complet de cet article est disponible en PDF.Abbreviations : CE, LES, NOD, NPV, PPV, SCE, UES
Plan
Vol 66 - N° 6
P. 1091-1095 - décembre 2007 Retour au numéro
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