Pan-enteric capsule for bleeding high-risk patients. Can we limit endoscopies?
| Autor: | María Fernández-Calderón, Iago Rodríguez-Lago, César Prieto-Frías, Miguel Muñoz Navas, Ramón Angós, Maite Herráiz Bayod, Cristina Carretero Ribón, Susana de la Riva Onandía, Maite Betés, Francisco Zozaya |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Population Capsule Endoscopy law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Capsule endoscopy law Gastroscopy Intestine Small medicine Humans education Retrospective Studies Creatinine education.field_of_study High risk patients medicine.diagnostic_test business.industry Gastroenterology Capsule General Medicine Endoscopy Surgery chemistry 030220 oncology & carcinogenesis Therapeutic endoscopy Panendoscopy 030211 gastroenterology & hepatology Gastrointestinal Hemorrhage business |
| Zdroj: | Revista Española de Enfermedades Digestivas. |
| ISSN: | 1130-0108 |
| DOI: | 10.17235/reed.2020.7196/2020 |
| Popis: | Introduction: obscure gastrointestinal bleeding is defined as bleeding from a source that cannot be identified on upper or lower gastrointestinal endoscopy and capsule endoscopy is the next step in these patients. Some patients may be unsuitable for conventional endoscopy and performing a capsule panendoscopic test as a first line procedure might potentially reduce the number of endoscopies and their subsequent risk. Aim: to analyze our experience with capsule endoscopy in the bleeding setting. Methods: the first 100 panendoscopic capsule procedures performed in our center from August 2011 until December 2016 were retrospectively reviewed. Results: positive findings were observed in 61.2 % of patients; 46.26 % had a previous negative gastroscopy and the capsule detected small bowel lesions in 67.7 % and colonic findings in 80.64 %. Taking into consideration that our population were high-risk patients (mainly because of comorbidities) and that we used up to 45 ml of sodium phosphate, sodium, potassium and creatinine changes were analyzed before and after procedure. The mean “before” values were 140.68, 4.04 and 1.36, respectively. The mean “after” values were 140.28, 3.9 and 1.35 (p = n.s.). According to our findings, no other endoscopic studies would be needed in 64.5 % of patients with negative gastroscopy. According to capsule results, conventional endoscopy could have been avoided in 68.6 % of cases. Conclusion: panendoscopy with a capsule may be useful and safe in bleeding high-risk patients, by selecting those who need therapeutic endoscopy, avoiding up to 68.6 % of diagnostic endoscopies in our series. |
| Databáze: | OpenAIRE |
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