Bowel preparation for small bowel capsule endoscopy - The later, the better!

Autor: Xavier S; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal. Electronic address: smaxavier@gmail.com., Rosa B; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal., Monteiro S; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal., Arieira C; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal., Magalhães R; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal., Cúrdia Gonçalves T; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal., Boal Carvalho P; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal., Magalhães J; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal., Moreira MJ; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal., Cotter J; Hospital Senhora da Oliveira, Guimarães - Gastroenterology Department, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal.
Jazyk: angličtina
Zdroj: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2019 Oct; Vol. 51 (10), pp. 1388-1391. Date of Electronic Publication: 2019 May 20.
DOI: 10.1016/j.dld.2019.04.014
Abstrakt: Background: In small bowel capsule endoscopy (SBCE), the presence of residue may compromise diagnostic accuracy.
Aims: To assess differences in quality of visualisation and diagnostic yield of SBCE using 3 different preparation protocols.
Methods: Prospective, randomized, blind, pilot study. Protocol A:Clear liquids diet the day before the examination with fasting from 8p.m.; Protocol B:Protocol A + 2 pouches of Moviprep ® (polyethylene glycol electrolyte solution + sodium ascorbate) in 1 L of water from 8p.m. of the day before the examination; Protocol C: Protocol A + 2 pouches of Moviprep ® in 1 L of water consumed after real-time confirmation of capsule arrival at small bowel. Small bowel preparation was classified by two experienced physicians, considering the percentage of the examination during which mucosal observation was adequate: Excellent(>90%); Good(90-75%); Fair(75-50%); Poor(<50%).
Results: 101 patients randomized to the 3 protocols (A 37, B 31, C 33 patients). Protocol C had an excellent/good small bowel preparation in a higher percentage of examinations for both readers(Reader 1-A:37.8% vs B:45.2% vs C:78.8%, p = 0.002 and Reader 2 -A:37.8% vs B:41.9% vs C:75.8%, p = 0.003). Also, protocol C had a higher detection of angioectasia (A:5.4% vs B:9.7% vs C:27.3%, p = 0.022).
Conclusions: The administration of Moviprep ® after the capsule had reached the small bowel was associated with a better small bowel preparation and a higher detection of angioectasia.
(Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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