A Simple 1-Day Colon Capsule Endoscopy Procedure Demonstrated to be a Highly Acceptable Monitoring Tool for Ulcerative Colitis
A Simple 1-Day Colon Capsule Endoscopy Procedure Demonstrated to be a Highly Acceptable Monitoring Tool for Ulcerative Colitis
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DOI：
10.1093/ibd/izy125
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发表时间：
2018-11-01
影响因子：
4.9
通讯作者：
Hibi, Toshifumi
中科院分区：
文献类型：
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作者：
Okabayashi, Shinji;Kobayashi, Taku;Hibi, Toshifumi
背景：第二代结肠胶囊内窥镜(CCE-2)已被报道为一种潜在的监测溃疡性结肠炎(UC)的工具。然而，其排泄率仍然不令人满意，肠道准备方案也不能很好地耐受性。此外，用于UC的标准肠道准备方案尚未建立。本研究的目的是开发一种简单的为期1天的CCE-2程序，同时评估其在UC中的排泄率和可接受性。评估与结肠通过时间和CCE-2可接受性相关的因素。方法：对33例患者进行前瞻性评估。分别于服药前2.5小时、服药后1小时、3小时和6小时摄取500毫升高渗聚乙二醇溶液和250毫升水，直至排出，第二次摄取时加入蓖麻油。对患者的Mayo肠镜评分(MES)和溃疡性结肠炎严重程度指数(UCEIS)进行分级，并评估其与粪便钙保护素(FC)的相关性。结果：CCE-2排泄率为93.9%(31/33)。CCE-2的可接受性优于CS(42.4%vs27.3%)。中位结肠通过时间为119min，与MES(P=0.010)、UCEIS(P=0.010)、FC(P=0.041)呈正相关。结论：新型CCE-2肠道准备方案对UC患者耐受性好，排泄率高。活动性疾病患者需要较长的结肠转运时间，这可能是导致CCE-2可接受性较低的原因。
Background: Second-generation colon capsule endoscopy (CCE-2) has been reported as a potential tool for monitoring ulcerative colitis (UC). However, its excretion rate is still unsatisfactory, and the bowel preparation regimen is not well tolerated. Furthermore, a standard bowel preparation regimen validated for UC has not been established. The aim of this study was to develop a simple 1-day CCE-2 procedure while evaluating its excretion rate and acceptability in UC. Factors associated with the colonic transit time and acceptability of CCE-2 were evaluated.Methods: Thirty-three patients were prospectively evaluated. Five hundred milliliters of hypertonic polyethylene glycol solution, followed by 250 mL of water, was ingested 2.5 hours before, then 1, 3, and 6 hours after capsule ingestion until its excretion, with castor oil added to the second ingestion. Mayo endoscopic subscore (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) were graded, and their correlations with fecal calprotectin (FC) were assessed. A questionnaire comparing CCE-2 with previous colonoscopy (CS) was conducted.Results: The excretion rate was 93.9% (31/33). The acceptability of CCE-2 was superior to CS (CCE-2 42.4% vs CS 27.3%). The median colonic transit time was 119 minutes and showed a positive correlation with MES (P = 0.010), UCEIS (P = 0.010), and FC (P = 0.041). CCE-2 was not favored by patients whose colonic transit times were longer.Conclusions: A novel bowel preparation regimen of CCE-2 was well tolerated, with a high excretion rate, by UC patients. Patients with active disease required longer colonic transit time, which may have resulted in the lower acceptability of CCE-2.