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DOI: 10.1055/s-0030-1262726
© Georg Thieme Verlag KG Stuttgart ˙ New York
Der Einsatz einer steuerbaren Endoskopiekapsel zur Untersuchung des Magens
Feasibility of Stomach Exploration with a Guided Capsule EndoscopePublication History
Publication Date:
22 December 2010 (online)
![](https://www.thieme-connect.de/media/endoheute/201004/lookinside/thumbnails/10.1055-s-0030-1262726-1.jpg)
Zusammenfassung
Hintergrund und Studienziele: Die Videokapselendoskopie ist in der Diagnostik von Dünndarmerkrankungen etabliert und sie wird für die Diagnostik von Ösophagus- und kolorektalen Erkrankungen evaluiert. Bisher war die Kapselendoskopie des Magens nicht durchführbar wegen des großen Volumens und der ausgedehnten Oberfläche. Wir präsentieren die erste Anwendung einer magnetisch navigierten Kapsel im menschlichen Magen. Patienten und Methoden: 29 Freiwillige und 24 Patienten (Männer 42, Frauen 11; mittleres Alter 47,5 Jahre) wurden in diese Machbarkeitsstudie einbezogen. Zur Steuerung einer Doppelsensor-Videokapsel innerhalb des menschlichen Magens, in dem durch die Aufnahme von 1300 ml Wasser innerhalb einer Stunde vor der Untersuchung eine Luft-Wasser-Grenzfläche vorhanden war, wurde ein flaches Magnetfeld benutzt. Die Visualisierung aller Magenabschnitte wurde versucht. Die Zeit zur Visualisierung wurde registriert und eine subjektive Beurteilung der Vollständigkeit der Visualisierung dokumentiert. Ergebnisse: Die technische Erfolgsrate betrug 98 %. Bei einem Patienten wurde ein technisches Versagen registriert. Bei den verbliebenen 52 Fällen konnten die Untersucher das Antrum in 98 %, den Korpus in 96 %, den Fundus in 73 % und die Kardia in 75 % vollständig visualisieren. Die mittlere Untersuchungszeit betrug 30 min (8–50 min), bei Freiwilligen aus Studiengründen mit einer längeren Zeit (im Mittel 37 min). Insgesamt wurden 30 Befunde identifiziert: 14 wurden sowohl bei der Gastroskopie als auch durch die Kapsel detektiert 10 Läsionen wurden nur durch die Kapselendoskopie identifiziert, 6 nur durch die Gastroskopie. Es traten keine relevanten kapselbezogenen Nebenwirkungen auf. Schlussfolgerung: Eine magnetisch navigierte Videoendoskopiekapsel scheint für die Magenuntersuchung geeignet und effektiv zu sein. Sie ermöglicht eine patientenfreundliche Untersuchung ohne Sedierung. Vergleichsstudien werden durchgeführt.
Abstract
Background and study aims: Video capsule endoscopy has been established in diagnosis of small-bowel disease and has been evaluated for esophageal pathology and recently for colorectal diagnostics. Gastric capsule endoscopy has not hitherto been feasible due to the stomach’s large surface area and volume. We present the first application of a magnetically navigated capsule in the human stomach. Patients and methods: 29 volunteers and 24 patients (men 42, women 11; mean age 47.5 years) were included in a feasibility study. Low-level magnetic fields were used to maneuver the double-sensor video capsule within the human stomach with an air-water interface provided by ingestion of 1300 ml water within 1 hour before examination. Visualization of all parts of the stomach was attempted; time for visualization was recorded, and a subjective assessment of completeness of visualization was documented. Results: There was technical failure in one individual; thus technical success rate was 98 %. In the 52 remaining cases, examiners assessed that the antrum, body, fundus, and cardia were fully visualized in 98 %, 96 %, 73 % and 75 %, respectively. Mean duration of examinations was 30 min (range 8–50), with a longer time (mean 37 min) for volunteers for study reasons. In total, 30 findings were identified: 14 were detected by both gastroscopy and capsule, 10 lesions were identified by guided capsule examination only, 6 by gastroscopy only. No significant capsule-related adverse events occurred. Conclusion: Magnetically navigated video capsule endoscopy appears to be feasible and sufficiently accurate for gastric examination. It may permit endoscopic examinations that are more patient-friendly and without sedation. Comparative studies are under way.
Schlüsselwörter
Gastroskopie - steuerbare Videokapsel
Key words
gastroscopy - guided video capsule
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