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Capsule Endoscopy Versus Colonoscopy in Patients With Previous Colorectal Surgery: A Prospective Comparative Study

机译:胶囊内窥镜检查患者患有先前结肠直肠手术的结肠镜检查:一个前瞻性的比较研究

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Background: Colonic capsule endoscopy (CCE) derived from the video capsule endoscopy, initially proposed to explore the small bowel, has demonstrated high sensitivity and specificity for colonic polyp detection. The primary outcome of the study was to assess the safety, feasibility, and reliability of CCE after colorectal surgery. Secondary outcomes were to identify the detection rate of colonic lesions and recognition of the surgical anastomosis as compared to colonoscopy. Methods: This is a prospective single-center study conducted over a 2-year period. Thirty-seven patients with a history of colorectal surgery were prospectively included in this study. Each patient received both CCE and colonoscopy, performed by different operators blinded to each other’s results. Results: Thirty-two patients (86.5%) completed the study and were included in the final analysis. All capsules were naturally expelled. In three patients (9.4%), the anal verge was not identified during the CCE recording and the examination of the colon was considered incomplete. Surgical anastomosis was accurately identified by CCE in 78.2% of the patients versus 93.8% for colonoscopy (P = 0.65). Thirty-eight lesions were detected in 14 patients. The sensitivity of CCE to detect colonic polyps was 95.2% (95% confidence interval (CI): 77.3-99.2%), the specificity 82.4% (95% CI: 59.0-93.8%). Positive predictive value (PPV) and negative predictive value (NPV) of CCE to detect colonic polyps were 87.0% and 93.3%, respectively. No complications related to the passage of the capsule through the intestinal anastomosis were detected. Conclusions: CCE proved to be safe and feasible, reporting a similar detection rate of colonic lesion compared to colonoscopy.
机译:背景技术:源自视频胶囊内窥镜检查的结肠胶囊内窥镜(CCE)最初提出探索小肠,已经表现出高敏感性和结肠息肉检测的特异性。该研究的主要结果是评估结直肠手术后CCE的安全性,可行性和可靠性。与结肠镜检查相比,二次结果是鉴定结肠病变的检出率和对外科吻合术的识别。方法:这是一个在2年期间进行的潜在单中心研究。本研究中预先包括三十七名患有结直肠手术史的患者。每个患者接受CCE和结肠镜检查,由不同的操作员蒙蔽了彼此的结果。结果:三十二名患者(86.5%)完成了该研究,并被列入最终分析。所有胶囊都自然排出。在三名患者(9.4%)中,在CCE记录期间没有识别肛门边缘,并考虑结肠的检查被认为是不完整的。通过CCE在78.2%的患者中准确鉴定外科吻合剂,用于结肠镜检查(P = 0.65)。 14名患者中检测到三十八个病变。 CCE检测结肠息肉的敏感性为95.2%(95%置信区间(CI):77.3-99.2%),特异性为82.4%(95%CI:59.0-93.8%)。 CCE的阳性预测值(PPV)和阴性预测值(NPV)分别为87.0%和93.3%。没有检测到通过肠吻合术通过胶囊通过的并发症。结论:CCE被证明是安全可行的,报告与结肠镜检查相比,结肠病变的类似检测率。

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