Screening of esophageal varices by esophageal capsule endoscopy: results of a French multicenter prospective study.
Endoscopy
; 47(6): 486-92, 2015 Jun.
Article
em En
| MEDLINE
| ID: mdl-25730284
ABSTRACT
BACKGROUND AND STUDY AIM:
Esophageal video capsule endoscopy (ECE) is a new technique that allows examination of the esophagus using a noninvasive approach. The aim of this study was to compare ECE with esophagogastroduodenoscopy (EGD) for the diagnosis of esophageal varices in patients with cirrhosis. PATIENTS ANDMETHODS:
A total of 330 patients with cirrhosis and with no known esophageal varices were prospectively enrolled. Patients underwent ECE first, followed by EGD (gold standard). The endoscopists who performed EGD were blind to the ECE result. Patient satisfaction was assessed using a visual analog scale (maximum score 100).RESULTS:
A total of 30 patients were excluded from the analysis because they did not undergo any endoscopic examinations. Patients (mean age 56 years; 216 male) had mainly alcoholic (45â%) or viral (27â%) cirrhosis. The diagnostic indices of ECE to diagnose and correctly stage esophageal varices were sensitivity 76â% and 64â%, specificity 91â% and 93â%, positive predictive value 88â% and 88â%, and negative predictive value 81â% and 78â%, respectively. ECE patient satisfaction scored significantly higher than EGD (87â±â22 vs. 58â±â35; Pâ<â0.0001).CONCLUSIONS:
ECE was well tolerated and safe in patients with liver cirrhosis and suspicion of portal hypertension. The sensitivity of ECE is not currently sufficient to replace EGD as a first exploration in these patients. However, due to its excellent specificity and positive predictive value, ECE may have a role in cases of refusal or contraindication to EGD. ECE might also improve compliance to endoscopic follow-up and aid important therapeutic decision making in the prophylaxis of bleeding. TRIAL REGISTRATION EudraCT (ID RCB 2009-A00532-55) and ClinicalTrials.gov (NCT00941421).
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Varizes Esofágicas e Gástricas
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Endoscopia do Sistema Digestório
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Endoscopia por Cápsula
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2015
Tipo de documento:
Article