Clinical Value Of Srting Esophageal Capsule Endoscopy In Esophageal Disease

Objective To investigate the safety,feasibility and diagnosis value of stringesophageal capsule endoscopy (SCE) for esophageal diseases.Methods A total of80patients with esophageal related symptoms wereperformed,who visited Department of Digestion in FuZhou General Hospital fromJuly2013to October2013. Esophageal capsule endoscopy(ECE) was improved witha string attached to both sides.They underwent the SCE with real-time viewingfollowed by esophagogastroduodenoscopy(EGD) after half an hour.The rate ofcompleting examination,detection of esophageal lesions,complications,procedure-related discomfort and adverse effects were compared.Results All of eighty patients completed the study. Five patients swallowed thecapsule into esophagus several times.The average of SCE examination time was(226.18±110.30)seconds and the average EGD examination time of esophaguswas(21.28±8.01) seconds. The highest mean discomfort score was caused by pullingout the SCE,followed by the string and pulling out the SCE.The SCE was mildtydifficult by68.75%of subjects, The discomfort score of SCE was less than that ofEGD(P＜0.05).The scores of swallow/insertion difficulty, throat discomfort,nauseaand vomiting by SCE were less than by EGD(all P＜0.05),but no statistic differenceswere found in score of cough or choke.119lesions were detected in74patients bySCE and EGD. SCE detected108lesions in70patients and EGD detected110lesionsin73patients.The diagnose accordance between SCE and EGD was82.35%(98/119).5lesions of esophageal high grade intraepithelial neoplasia and3lesions of early esophageal squamous carcinoma (all comfirmed by histopathologicexamination) were detected by both examination.The positive rate of esophageallesions by SCE was lower than that of EGD (χ2=0.592，P＞0.05). The sensitivity,specificity, positive predictive value, and negative predictive value of SCE for the esophageal diseases were94.52%、85.71%、97.18%and60.00%.Gum bleeding wasfound in one patient after SCE,and7patients had bleeding of throat after EGD.Theoverall rate of complication in EGD was significantly higher than that inSCE(χ2=4.238，P=0.040).91.3%(73/80)patients preferred SCE to EGD. If they haveto undergo a repeated examination,87.50%(73/80)patients preferred SCE over EGD.Conclusions SCE is an easy-to-operate,safe,short operation time,reusable,welltoleranted and accurate examination to esophagus disease.The procedure-relateddiscomfort and adverse effects of SCE are less than those of EGD.SCE may be anavailable noninvasive methord in diagnosing the esophageal disease.