The effect of swallowing intervention on improving the esophageal examination by magnetically controlled capsule endoscopy: a cohort study / 中华消化杂志

ABSTRACT

Objective:To investigate the effect and feasibility of swallowing intervention on esophageal examination by magnetically controlled gastric capsule endoscope (MCE), and to provide theoretical evidence for clinical application.Methods:From January 2021 to May 2022, 196 subjects who underwent MCE examination at West China Hospital, Sichuan University were prospectively enrolled. According to the swallowing action during MCE procedure, the subjects were divided into routine examination control group and swallowing-controlled intervention group with 98 cases in each group. The data of gender, age, history of smoking and drinking, body mass index, clinical symptoms (abdominal pain or abdominal distension, hematochezia, melena or positive fecal occult-bloodtest), esophageal transit time of MCE and detection rate of esophageal lesions were compared between the 2 groups. Wilcoxon rank sum test and chi-square test were used for statistical analysis.Results:There were no significant differences in age, gender, smoking history, drinking history, body mass index, history of diabetes, history of hypertension, and indication of MCE examination between the routine examination control group and swallowing-controlled intervention group (all P>0.05). All the subjects successfully completed the examination, and the capsules were excreted from the body. The median esophageal transit time of swallowing-controlled intervention group was longer than that of the routine examination control group (44.50 s (26.75 s, 101.25 s) vs. 11.00 s (5.00 s, 29.00 s)), and the difference was statistically significant ( Z=-8.13, P<0.001). The esophageal transit time of the patients aged 40 to 59 years old was longer than that of the patients aged <40 years old, but shorter than that of the patients aged ≥60 years old (54.00 s (36.25 s, 64.75 s) vs. 28.00 s (23.00 s, 35.00 s) and 69.50 s (64.75 s, 73.00 s)), and the differences were statistically significant ( Z=-6.72 and -6.91, both P<0.001). The detection rate of esophageal lesions of swallowing-controlled intervention group was higher than that of routine examination control group (22.4%, 22/98 vs. 11.2%, 11/98), and the difference was statistically significant ( χ2=4.41, P=0.036). Conclusion:Command-controlled swallowing can effectively prolong the time of esophagus examination by MCE, and improve the detection rate of esophageal lesions by MCE.