Capsule enteroscopy is useful for the therapeutic management of Crohn's disease

被引:10
|
作者
Santos-Antunes, Joao [1 ,2 ]
Cardoso, Helder [1 ]
Lopes, Susana [1 ]
Marques, Margarida [1 ]
Nunes, Amadeu C. R. [1 ]
Macedo, Guilherme [1 ]
机构
[1] Hosp Sao Joao, Fac Med, Dept Gastroenterol, P-4200319 Oporto, Portugal
[2] Univ Porto, Fac Med, Dept Biochem FCT U38, P-4200319 Oporto, Portugal
关键词
Capsule enteroscopy; Crohn's disease; Treatment modification; Patency capsule; Lewis score; INFLAMMATORY-BOWEL-DISEASE; MUCOSAL HEALING ASSESSMENT; CARE CENTER EXPERIENCE; POSTOPERATIVE RECURRENCE; ENDOSCOPY; DIAGNOSIS; IMPACT;
D O I
10.3748/wjg.v21.i44.12660
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
AIM: To analyze therapeutic changes in Crohn's disease (CD) patients following video capsule endoscopy (VCE) and to assess the usefulness of Lewis score and the Patency Capsule. METHODS: Patency Capsule was performed in every patient that had indication for VCE, and those with negative patency did not undergo VCE. Patients with established CD that underwent VCE between January 2011 and February 2014 were selected for this study; those with suspected CD were excluded, independent of VCE results, since our purpose was to address differences in therapeutic regimen in CD patients before and after VCE. Patients with inconclusive VCE were also excluded. Patients had to be free of non-steroidal anti-inflammatories for at least 1 mo. Those patients who met these criteria were allocated into one of three groups: Staging group (asymptomatic CD patients that underwent VCE for staging of CD), Flare group (patients with active CD), or Post-op group (CD patients evaluated for post-operative recurrence). Lewis score was calculated for every VCE procedure. Statistical analysis was performed to address the impact of VCE findings on the therapeutic management of CD patients and to evaluate the utility of the Lewis score. RESULTS: From a total of 542 VCEs, 135 were performed in patients with CD. Patency capsule excluded nearly 25% of the patients who were supposed to undergo VCE. No videocapsule retention during VCE was reported. From these 135 patients, 29 were excluded because CD diagnosis was not established at the time of VCE. Therefore, a total of 106 patients were included in the final analysis. From these, the majority were in the Staging group (n = 73, 69%), and the remaining were in the Flare (n = 23, 22%) or Post-op (n = 10, 9%) group. Median time between diagnosis and VCE was 5.5 years. Overall, VCE determined changes in the treatment of 40% of patients: only 21% remained free of immunosuppressors after VCE compared to 44% before VCE (p < 0.001). The differences in therapy before and after VCE achieved statistical significance in the Staging and Flare groups. In addition, patients were significantly different when stratified regarding time since diagnosis to the date of VCE. A higher Lewis score was associated with therapeutic modifications (p < 0.0001); where a score higher than 1354 was related to 90% probability of changing therapy [area under the receiver operative characteristic (AUROC) 0.80 (95% CI: 0.69- 0.88)]. CONCLUSION: VCE significantly changed the therapeutic management of CD patients, even in those with long-term disease. Systematic use of Patency capsule allowed for no videocapsule retention.
引用
收藏
页码:12660 / 12666
页数:7
相关论文
共 50 条
  • [21] Diagnostic and therapeutic impact of double balloon enteroscopy in patients with Crohn's disease
    Bellutti, Michael
    Fry, Lucia C.
    MoNkemuLler, Klaus
    Neunnn, Heltnut
    Von Arnim, Ulrike
    Malfertheiner, Peter
    GASTROINTESTINAL ENDOSCOPY, 2008, 67 (05) : AB271 - AB271
  • [22] Utility of wireless capsule enteroscopy (WCE) in evaluating Crohn's disease patients with abdominal symptoms
    Mehdizadeh, S
    Chen, GC
    Enayati, PJ
    Shaye, O
    Lo, SK
    Papadakis, KA
    GASTROINTESTINAL ENDOSCOPY, 2005, 61 (05) : AB175 - AB175
  • [23] A review of the therapeutic management of Crohn's disease
    Kumar, Aditi
    Cole, Alexander
    Segal, Jonathan
    Smith, Philip
    Limdi, Jimmy K.
    THERAPEUTIC ADVANCES IN GASTROENTEROLOGY, 2022, 15
  • [24] Is wireless capsule endoscopy useful in diagnosing small bowel Crohn's disease?
    Voderholzer, WA
    Beinhoelzl, J
    Rogalla, P
    Neye, H
    Weber, J
    Schachschal, G
    Lochs, H
    Ortner, MA
    GASTROINTESTINAL ENDOSCOPY, 2002, 55 (05) : AB139 - AB139
  • [25] Wireless capsule enteroscopy: A comparison with enterography, push enteroscopy and ileo-colonoscopy in the diagnosis of small bowel Crohn's disease
    Toth, E
    Fork, FT
    Almqvist, P
    Benoni, C
    Ekberg, O
    Grip, O
    Gustafson, T
    Lindgren, S
    Ohlsson, B
    Olsson, R
    Sjoberg, K
    Verbaan, H
    GASTROINTESTINAL ENDOSCOPY, 2004, 59 (05) : AB173 - AB173
  • [26] The impact of panenteric capsule endoscopy on the management of Crohn's disease
    Eliakim, Rami
    THERAPEUTIC ADVANCES IN GASTROENTEROLOGY, 2017, 10 (09) : 737 - 744
  • [27] Impact of Capsule Endoscopy Findings in the Management of Crohn's Disease
    Lorenzo-Zuniga, Vicente
    Moreno de Vega, Vicente
    Domenech, Eugeni
    Cabre, Eduard
    Manosa, Miriam
    Boix, Jaume
    DIGESTIVE DISEASES AND SCIENCES, 2010, 55 (02) : 411 - 414
  • [28] Impact of Capsule Endoscopy Findings in the Management of Crohn’s Disease
    Vicente Lorenzo-Zúñiga
    Vicente Moreno de Vega
    Eugeni Domènech
    Eduard Cabré
    Míriam Mañosa
    Jaume Boix
    Digestive Diseases and Sciences, 2010, 55 : 411 - 414
  • [29] The Utility of Capsule Endoscopy for the Diagnosis and Management of Crohn's Disease
    Buchner, Anna
    Lichtenstein, Gary
    Blonski, Wojciech
    AMERICAN JOURNAL OF GASTROENTEROLOGY, 2014, 109 : S499 - S499
  • [30] The value of small bowel capsule endoscopy in the change of therapeutic management in patients with established Crohn's disease
    Viazis, N.
    Tsoukali, E.
    Pontas, C.
    Karampekos, G.
    Gkeros, F.
    Filippidis, G.
    Vraka, M.
    Koustenis, K.
    Mountaki, K.
    Mitselos, I.
    Mela, M.
    Christidou, A.
    Archavlis, E.
    Vienna, E.
    Christodoulou, D.
    Mantzaris, G.
    JOURNAL OF CROHNS & COLITIS, 2020, 14 : S484 - S485