Video capsule endoscopy compared with standard endoscopy for the evaluation of small-bowel polyps in persons with familial adenomatous polyposis (with video)
Autor: | Aniko Szabo, Lisa Pappas, Maydeen Ogara, Ashok K. Tuteja, Derrick Haslem, Robert F. Wong, James A. DiSario |
---|---|
Rok vydání: | 2006 |
Předmět: |
Adult
Male medicine.medical_specialty Duodenum Biopsy Capsule Endoscopy Sensitivity and Specificity Gastroenterology Endoscopy Gastrointestinal law.invention Familial adenomatous polyposis Video capsule endoscopy Duodenal Neoplasms Interquartile range Capsule endoscopy law Internal medicine otorhinolaryngologic diseases medicine Humans Radiology Nuclear Medicine and imaging In patient Prospective Studies Prospective cohort study neoplasms Aged Observer Variation Jejunal Neoplasms Tattooing medicine.diagnostic_test business.industry Middle Aged medicine.disease digestive system diseases Endoscopy Jejunum Adenomatous Polyposis Coli Female business |
Zdroj: | Gastrointestinal Endoscopy. 64:530-537 |
ISSN: | 0016-5107 |
Popis: | Background Video capsule endoscopy (VCE) may be useful for surveillance of small-bowel polyps in patients with familial adenomatous polyposis (FAP). Objective To compare VCE to standard endoscopy for diagnosing small-bowel polyps in a defined segment of small bowel (proximal to a tattoo) and the entire examined small bowel. Design Prospective. Setting Single tertiary referral center. Patients Participants with FAP (n = 32). The majority were selected for their high number of proximal small-bowel polyps and prior endoscopic tattoo placement in the proximal small bowel. Interventions VCE (interpreted by 2 readers), push enteroscopy (PE), and lower endoscopy (LE) to count and measure small-bowel polyps. Results In the defined segment, VCE detected a median of 10.0 (interquartile range [IQR], 5.0-19.0) and 9.0 (IQR, 6.0-16.0) polyps for each reader compared with a median of 41.0 (IQR, 19.0-64.0) polyps on PE ( P = .002). Agreement between the 2 methods was fair (κ = 0.34, 0.36). Agreement between VCE and PE was poor to fair (κ = 0.10, 0.22) for estimating the size of the largest polyp and poor (κ = −0.20, −0.27) for detecting large polyps (≥1 cm). In the entire examined small bowel, VCE diagnosed a median of 38.0 (IQR, 10.5-71.5) and 54.0 (IQR, 13.0-100.0) polyps for each reader compared with a median of 123.0 (IQR, 38.5-183.0) for combination endoscopy (PE and LE) ( P Limitations Participants selected for high polyp burden, and results may not be applicable to all patients with FAP. Conclusions VCE underestimates the number of small-bowel polyps in persons with FAP and does not reliably detect large polyps. |
Databáze: | OpenAIRE |
Externí odkaz: |