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Objective:To explore the value of detachable string-magnetically controlled capsule endoscopy (DS-MCE) in the evaluation of post-endoscopic treatment of liver cirrhosis patients with gastroesophageal varices during follow-up, and conventional electronic esophagogastroduodenoscopy (EGD) was used as the gold standard.Methods:From July 1, 2019 to December 31, 2021, 50 follow-up patients with gastroesophageal varices due to liver cirrhosis and had a past medical history of endoscopic treatment in Ruijin Hospital, Shanghai Jiaotong University School of Medicine were selected. DS-MCE and EGD were performed in turn. The 2 endoscopic examination methods were compared and analyzed in the assessment of detecting gastroesophageal varices, grading of diameter of esophageal varices and classification of bleeding risk factors (including sensitivity, specificity, positive predictive value and negative predictive value), diagnosis of portal hypertensive gastropathy and its severity, and the patients′ satisfaction (pre-procedural perceptual and post-procedural satisfaction). Kruskal-Wallis test and Kappa test were used for statistical analysis.Results:The sensitivity, specificity, positive predictive value and negative predictive value of DS-MCE in the diagnosis of esophageal varices were 100.0% (43/43), 85.7%(6/7), 97.7% (43/44) and 100.0%(6/6), respectively.The accuracy of DS-MCE in evaluating the grading of esophageal varices was 86.0% (43/50), with good consistency of EGD, and the Kappa value was 0.797 ( P<0.001). The sensitivity, specificity, positive predictive value and negative predictive value of DS-MCE in the diagnosis of esophageal varices with bleeding risk factors were 94.4% (34/36), 100.0%(14/14), 100.0% (34/34) and 87.5%(14/16), respectively. The accuracy of DS-MCE in evaluating esophageal varices with bleeding risk factors was 94.0% (47/50), with good consistency of EGD, and the Kappa value was 0.862 ( P<0.001). The sensitivity, specificity, positive predictive value and negative predictive value of DS-MCE in the diagnosis of gastric varices were 85.7% (18/21), 93.1% (27/29), 90.0% (18/20) and 90.0% (27/30), respectively. The sensitivity, specificity, positive predictive value and negative predictive value of DS-MCE in the diagnosis of portal hypertensive gastropathy were all 100.0% (50/50). The consistency of DS-MCE and EGD in the severity grading of portal hypertensive gastropathy was good, the Kappa value was 0.962 ( P<0.001). The results of pre-procedural perceptual analysis showed that patients′ psychological tension before examination and expected pain before examination of DS-MCE were better than those of EGD ( H=16.04 and 23.74, both P<0.001). The results of satisfactory analysis after examination indicated that DS-MCE was better than EGD in the degree of difficulty in swallowing, pain and discomfort during examination, pain and discomfort after examination, comfort degree during examination, convenience of the procedure and willingness of receiving such examination again as gastric examination method ( H=17.28, 30.88, 44.68, 34.66, 48.05, 22.74, 13.03 and 17.19, all P<0.001). Conclusions:With EGD as the gold standard, DS-MCE can accurately evaluate gastroesophageal varices and portal hypertensive gastroenteropathy after endoscopic treatment in patients with liver cirrhosis and gastroesophageal varices, and it is a safe and comfortable method. DS-MCE can be an efficient alternative method in endoscopic follow-up of such patients.
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OBJECTIVE@#To investigate the effects of Weikang Capsule (, WKC) on aspirin-related gastric and small intestinal mucosal injury by magnetically controlled capsule endoscopy (MCCE).@*METHODS@#Patients taking enteric-coated aspirin aged 40-75 years were enrolled in Beijing Anzhen Hospital, Capital Medical University from January 2019 to December 2019. The patients continued taking aspirin Tablet (100 mg per day) and underwent MCCE before and after 1-month combined treatment with WKC (0.9 g per time orally, 3 times per day). The gastrointestinal symptom score, gastric Lanza score, the duodenal, jejunal and ileal mucosal injury scores were used to evaluate the gastrointestinal injury before and after treatment. Adverse events including nausea, vomiting, abdominal pain, abdominal distension, abdominal discomfort, dizziness, or headache during MCCE and combined treatment were observed and recorded.@*RESULTS@#Twenty-two patients (male/female, 13/9) taking enteric-coated aspirin aged 59.5 ± 11.3 years with a duration of aspirin use of 28.0 (1.0, 48.0) months were recruited. Compared with pre-treatment, the gastrointestinal symptom rating scale scores, gastric Lanza scores, and duodenal mucosal injury scores were significantly reduced after 1-month WKC treatment (P<0.05), and jejunal and ileal mucosal injury scores showed no obvious change. No adverse events occurred during the trial.@*CONCLUSIONS@#WKC can alleviate gastrointestinal symptoms, as well as gastric and duodenal mucosal injuries, in patients taking enteric-coated aspirin; it does not aggravate jejunal or ileal mucosal injury, which may be an effective alternative for these patients (Clinical trial registry No. ChiCTR1900025451).
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Objective To study the clinical value of magnetically controlled capsule endoscopy in diseases screening. Method We retrospectively analyzed 61 cases which were evaluated by magnetically controlled capsule endoscopy from March 2015 to December 2016. The items include operating time, the divergence rate score and cleanliness score of stomach. The consistency was compared between magnetically controlled capsule endoscopy and gastric duodenal endoscopy. Results 61 upper gastrointestinal tract studies were included. The mean age was (49.4 ± 11.6) years. No capsule retention, perforation or bleeding occurred. There was 98.4% patients, which cleanliness of stomach was good. There was 68.9% patients, which filling degree of stomach was good. The concordance rate of the two tests of gastrduodenoscopy and magnetically controlled capsule endoscopy was 89.9% (80/89). The concordance rate of the two tests was 78.9% (15/19) in esophageal and cardia, 92.9% (52/56) in stomach, 92.9% (13/14) in duodenum. Conclusion Our experience shows that magnetically controlled capsule endoscopy is a safe and useful tool for the diagnosis of upper gastrointestinal tract disease. The detection rate is similar to gastrduodenoscopy.