Abstract Abstract Background: Video capsule endoscopy (VCE) will fail to reach the cecum in 20% of patients within the 8-hour battery life. The use of prokinetics to improve VCE completion rates to the cecum remains u...Abstract Abstract Background: Video capsule endoscopy (VCE) will fail to reach the cecum in 20% of patients within the 8-hour battery life. The use of prokinetics to improve VCE completion rates to the cecum remains unclear. The objective of this study was to determine whether erythromycin increases the completion rate of VCE to the cecum without adversely affecting image quality. Methods: This was a prospective, randomized, single-blinded control trial at St. Vincent’ s Hospital, Melbourne, Australia. A total of 86 consecutive patients referred for VCE were considered for entry; 45 patients met the entry criteria. These 45 patients were prospectively randomized to no erythromycin (controls, n = 23) or 250 mg erythromycin (n = 22). Two gastroenterologists, who were unaware of which group the patients were randomized into, reported all VCEs. The number of VCEs that reached the cecum within the 8-hour study period, gastric emptying time (GET), and small-bowel transit time (SBTT) were calculated for each group. Results: There was no significant difference in the number of VCEs that reached the cecum (32% failed to reach the cecum in the erythromycin group compared with 22% in the control group), GET, or SBTT between the two groups. Image quality was not adversely affected by the use of erythromycin. The dose and the preparation of erythromycin used in this study may have possibly had an effect on GET and SBTT. Conclusions: The use of erythromycin did not significantly increase the likelihood of the capsule reaching the cecum or affect the degree of visible peristalsis or the interpretation of capsule findings.展开更多
Background: The diagnosis of small- bowel Crohn’ s disease sometimes is dif ficult and may be missed by conventional imaging studies. Capsule endoscopy migh t identify small- bowel disease undetected by other investi...Background: The diagnosis of small- bowel Crohn’ s disease sometimes is dif ficult and may be missed by conventional imaging studies. Capsule endoscopy migh t identify small- bowel disease undetected by other investigations. Methods: Pa tients with or without known Crohn’ s disease who were suspected to have small - bowel Crohn’ s disease were prospectively evaluated with push enteroscopy, e nteroclysis, and capsule endoscopy. Each examiner was blinded to results of othe r investigations. Referring doctors were required to complete questionnaires bef ore and after the investigations. Results: Twenty- two patients were known to h ave Crohn’ s disease (Group 1), and 21 were suspected to have small- bowel Cro hn’ s disease (Group 2). In Group 1, capsule endoscopy detected more erosions t han the other two investigations (p< 0.001). In Group 2, a new diagnosis of Croh n’ s disease was made in two patients, but there was no significant difference in yield compared with the other two investigations. Referring physicians rated the usefulness of capsule endoscopy a s 4.4 on a scale of 5. Capsule endoscopy changed management for 30 patients (70 % ). Conclusions: Capsule endoscopy has a higher yield than push enteroscopy an d enteroclysis in patients with known Crohn’ s disease when small- bowel mucos al disease is suspected, and this leads to a change in management in the majorit y of these patients.展开更多
Background: Studies on the clinical impact of EUS are lacking. The aim of this study was to examine the impact of EUS on the management plans by referring doctors and patient outcomes. Methods: Consecutive patients un...Background: Studies on the clinical impact of EUS are lacking. The aim of this study was to examine the impact of EUS on the management plans by referring doctors and patient outcomes. Methods: Consecutive patients undergoing EUS between August 2002 and June 2004 were prospectively studied. Referring doctors were given a pre-EUS questionnaire that asked about provisional diagnosis and management plan. A post-EUS questionnaire was sent 6 weeks after the procedure. Results: A total of 330 patients were examined, and completed questionnaires were received in 70% . EUS-guided FNA was performed in 69 (30% ) patients. EUS resulted in a change in diagnosis and management in 26% and 48% of cases, respectively. Thirty-nine of the latter patients (33% ) avoided unnecessary surgery. In 50% of cases, additional investigations were avoided. Doctors reported EUS as very or moderately useful in 210 patients (91% ). Doctors of 223 patients (97% ) reported that they would use EUS again. Conclusions: The use of EUS had a significant clinical impact on patients. EUS resulted in a change of diagnosis in a fourth of patients and a change in management in half of patients studied.展开更多
文摘Abstract Abstract Background: Video capsule endoscopy (VCE) will fail to reach the cecum in 20% of patients within the 8-hour battery life. The use of prokinetics to improve VCE completion rates to the cecum remains unclear. The objective of this study was to determine whether erythromycin increases the completion rate of VCE to the cecum without adversely affecting image quality. Methods: This was a prospective, randomized, single-blinded control trial at St. Vincent’ s Hospital, Melbourne, Australia. A total of 86 consecutive patients referred for VCE were considered for entry; 45 patients met the entry criteria. These 45 patients were prospectively randomized to no erythromycin (controls, n = 23) or 250 mg erythromycin (n = 22). Two gastroenterologists, who were unaware of which group the patients were randomized into, reported all VCEs. The number of VCEs that reached the cecum within the 8-hour study period, gastric emptying time (GET), and small-bowel transit time (SBTT) were calculated for each group. Results: There was no significant difference in the number of VCEs that reached the cecum (32% failed to reach the cecum in the erythromycin group compared with 22% in the control group), GET, or SBTT between the two groups. Image quality was not adversely affected by the use of erythromycin. The dose and the preparation of erythromycin used in this study may have possibly had an effect on GET and SBTT. Conclusions: The use of erythromycin did not significantly increase the likelihood of the capsule reaching the cecum or affect the degree of visible peristalsis or the interpretation of capsule findings.
文摘Background: The diagnosis of small- bowel Crohn’ s disease sometimes is dif ficult and may be missed by conventional imaging studies. Capsule endoscopy migh t identify small- bowel disease undetected by other investigations. Methods: Pa tients with or without known Crohn’ s disease who were suspected to have small - bowel Crohn’ s disease were prospectively evaluated with push enteroscopy, e nteroclysis, and capsule endoscopy. Each examiner was blinded to results of othe r investigations. Referring doctors were required to complete questionnaires bef ore and after the investigations. Results: Twenty- two patients were known to h ave Crohn’ s disease (Group 1), and 21 were suspected to have small- bowel Cro hn’ s disease (Group 2). In Group 1, capsule endoscopy detected more erosions t han the other two investigations (p< 0.001). In Group 2, a new diagnosis of Croh n’ s disease was made in two patients, but there was no significant difference in yield compared with the other two investigations. Referring physicians rated the usefulness of capsule endoscopy a s 4.4 on a scale of 5. Capsule endoscopy changed management for 30 patients (70 % ). Conclusions: Capsule endoscopy has a higher yield than push enteroscopy an d enteroclysis in patients with known Crohn’ s disease when small- bowel mucos al disease is suspected, and this leads to a change in management in the majorit y of these patients.
文摘Background: Studies on the clinical impact of EUS are lacking. The aim of this study was to examine the impact of EUS on the management plans by referring doctors and patient outcomes. Methods: Consecutive patients undergoing EUS between August 2002 and June 2004 were prospectively studied. Referring doctors were given a pre-EUS questionnaire that asked about provisional diagnosis and management plan. A post-EUS questionnaire was sent 6 weeks after the procedure. Results: A total of 330 patients were examined, and completed questionnaires were received in 70% . EUS-guided FNA was performed in 69 (30% ) patients. EUS resulted in a change in diagnosis and management in 26% and 48% of cases, respectively. Thirty-nine of the latter patients (33% ) avoided unnecessary surgery. In 50% of cases, additional investigations were avoided. Doctors reported EUS as very or moderately useful in 210 patients (91% ). Doctors of 223 patients (97% ) reported that they would use EUS again. Conclusions: The use of EUS had a significant clinical impact on patients. EUS resulted in a change of diagnosis in a fourth of patients and a change in management in half of patients studied.
