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Risk factors for surgery in patients with retention of endoscopic capsule.
Han, Zemin; Qiao, Weiguang; Ai, Xiuyun; Li, Aimin; Chen, Zhenyu; Zhang, Jie; Wan, Tianmo; Feng, Xicheng; Liu, Side; Zhi, Fachao.
Afiliação
  • Han Z; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
  • Qiao W; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
  • Ai X; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
  • Li A; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
  • Chen Z; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
  • Zhang J; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
  • Wan T; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
  • Feng X; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
  • Liu S; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
  • Zhi F; a Guangdong Provincial Key Laboratory of Gastroenterology , Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University , Guangzhou , China.
Scand J Gastroenterol ; 53(1): 107-113, 2018 Jan.
Article em En | MEDLINE | ID: mdl-29043867
ABSTRACT

OBJECTIVES:

Surgery is still the main means for removing retained endoscopic capsules. This study intended to evaluate risk factors for surgery in patients with capsule retention. MATERIALS AND

METHODS:

The data of 5348 consecutive capsule endoscopy examinations were retrospectively analyzed. Cox regression analysis was used to evaluate risk factors.

RESULTS:

Seventy-seven patients (1.4%) had capsule retention. Spontaneous passage occurred in 16 patients, of which 14 were asymptomatic. Successful retrieval by double-balloon enteroscopy (DBE) was achieved in 14 patients, of which 11 did not need surgery during clinical follow-up. A total of 50 patients underwent surgery. The cumulative rates of surgery were 44.2%, 53.2%, 55.8%, 62.3% and 64.9% at 1, 3, 6, 12 and 60 months after capsule retention, respectively. Intestinal obstruction [hazard ratio (HR) 2.05, 95% confidence interval (CI) 1.12-3.76; p = .020] and overt small bowel bleeding (HR 2.01, 95%CI 1.08-3.71; p = .027) during capsule retention were independently associated with an increased risk for surgery. Specific treatment for primary disease (HR 0.22, 95%CI 0.07-0.74, p = .014) and successful endoscopic retrieval (HR 0.20, 95%CI 0.06-0.66; p = .008) were independently associated with a decreased risk for surgery.

CONCLUSIONS:

For asymptomatic patients, specific medical treatment for primary disease can be maintained until the capsule spontaneously passes or symptoms appear. For patients with slight abdominal pain, DBE can be performed. For patients with intestinal obstruction or overt small bowel bleeding, early surgical consultation should be considered.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Endoscopia por Cápsula / Corpos Estranhos / Hemorragia Gastrointestinal / Obstrução Intestinal Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Endoscopia por Cápsula / Corpos Estranhos / Hemorragia Gastrointestinal / Obstrução Intestinal Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article