Aims Magnetically controlled capsule endoscopy (MCCE) provides the opportunity for the non-invasive endoscopic screening of the upper gastrointestinal tract before small bowel capsule endoscopy (SBCE). Our recent in-vitro study gave preliminary evidence for the optimal setting of the outer magnetic field of the Ankon MCCE system to enhance the visualization of the cardia. Therefore, we aimed to compare the in-vivo visibility of the distal esophagus and the Z-line by different capsule swallowing protocols.
Methods Sixty consecutive patients, scheduled for SBCE with Ankon MCCE, were enrolled. Thirty of them (group A: 42 years; 53 % female) swallowed the capsule in the modified left lateral position, leaning on their left forearms and elbows, while the outer magnet was positioned tightly against their backs, with magnetic field vectors (X,Y,Z axis) 180, -90 and 90 degrees, respectively. Thirty further patients (group B: 43 years; 47 % female) swallowed the capsules in the same way but were asked to turn slowly on their back (supine position) as soon as the capsule passed the pharynx. The outer magnet was then positioned above their chest over the cardia.
Results Both the esophageal transit time (82±105 vs. 24±25 seconds, p < 0.05) and the mean number of esophageal images (423±507 vs. 120±143 images, p < 0.05) were significantly increased in group B compared to group A. Furthermore, patients in group B had significantly higher rates of both partial (90 vs. 36 %, p < 0.005) and complete Z-line visibility 73 vs. 23 %, p < 0.005). Of the studied 60 patients 22 (36.6 %) had erosive reflux esophagitis and 1 (1.7 %) had Barrett’s esophagus.
Conclusions Application of our new MCCE protocol significantly improved the visibility of the distal esophagus and the Z-line. Further prospective randomized studies with a larger number of cases are needed to validate the results and compare the diagnostic yield with standard upper GI endoscopy.
Citation:
Finta A, Szalai M, Lovasz BD et al. eP101 MAGNETICALLY CONTROLLED CAPSULE ENDOSCOPY (MCCE) IMPROVES DISTAL ESOPHAGEAL MUCOSAL AND CIRCUMFERENTIAL Z-LINE VISIBILITY. Endoscopy 2021; 53: S129.
