UEGJournal Abstracts 2021 - 858

Endoscopy and imaging
References:
1. Nakazawa, K., et al., The Differential Diagnosis of Colorectal Polyps Using
Colon Capsule Endoscopy. Intern Med, 2021.
2. Spada, C., et al., Colon capsule endoscopy: European Society of Gastrointestinal
Endoscopy (ESGE) Guideline. Endoscopy, 2012. 44(5): p. 527-36.
Disclosure: The authors of this abstract have no conflicts of interest to
declare.
P1039
MAGNETIC-ASSISTED CAPSULE ENDOSCOPY IN CHILDREN:
PRELIMINARY REPORT ON FEASIBILITY, SAFETY AND IMPACT ON
GASTRIC TRANSIT TIME.
G. Di Nardo1
, V.D. Corleto2
, C. Pacchiarotti1
, F. Micheli2
, P. Parisi1
F. Baccini2, C. Ziparo1, L. Zenzeri1, F. Vassallo1, C. Fanfoni1
1
Sapienza University of Rome, Sant'Andrea University Hospital,
NESMOS Department, Rome, Italy, 2
,
Sapienza University of Rome,
Sant'Andrea University Hospital, Department of Medical-Surgical
Sciences and Translational Medicine, Rome, Italy
Contact E-Mail Address: zenzeriletizia@gmail.com
Introduction: Standard capsule endoscopy (CE) is ineffective for upper
gastrointestinal (GI) tract examination because it does not allow operatorcontrolled
navigation of the capsule. Furthermore, delayed transpyloric
passage of the capsule may result in an incomplete small bowel examination.
Magnetically assisted capsule endoscopy (MACE) may offer a solution
to these problems and it could represent an alternative to gastroscopy
(EGD) in specific clinical settings such as follow-up of pediatric non stricturing
Crohn's disease (CD) in which biopsies are not needed.
Aims & Methods: This pilot study is aimed to evaluate the MACE feasibility
and safety in pediatric CD and if transpyloric passage could be hastened
by external magnetic control of the capsule.
Pediatric CD patients already studied by standard small bowel CE before
May 2020 were enrolled. All participants swallowed a MACE (MiroCam
Navi, Intromedic, Seoul, Korea), and an external magnetic field navigator
was used to guide the capsule through the upper GI tract. The maneuverability
and difference in the pyloric transit time (PTT) between standard
CE and MACE were assessed.
Results: Ten pediatric CD patients [mean age 11,4 years (range 6-15); 60%
male] were enrolled from June 2020 to March 2021. The capsule maneuverability
was defined as good, fair, and poor in 50%, 20%, and 30%, respectively.
MACE maneuverability and mucosal assessment were mainly
hindered by residual gastric content (i.e. mucus, bubbles). The complete
examination of the esophageal and gastric mucosa was achieved in 80%
and 70%, respectively. Transpyloric passage of the capsule under magnetic
control was successfully performed in 8/10 patients. Median PTT was
greatly reduced with MACE compared to the standard CE [29,1 minutes
(range, 18.2-38.6) vs 64,4 minutes (range, 42,4-102,3); P < 0.001]. No significant
adverse events occurred.
Conclusion: MACE is feasible and safe in children with non-stricturing CD.
Furthermore, it is satisfactorily maneuverable allowing a complete visualization
of upper GI mucosa and could be helpful to improve transpyloric
passage of the capsule avoiding incomplete small bowel examinations.
Larger randomized studies are needed to evaluate the non-inferiority/
superiority of MACE over EGD and standard CE in this specific clinical setting.
References:
Lien
GS, Wu MS, Chen CN, et al. Feasibility and safety of a novel magnetic-assisted
capsule endoscope system in a preliminary examination
for upper gastrointestinal tract. Surg Endosc. 2018;32(4):1937-1944. doi:
10.1007/s00464-017-5887-0.
858
Ching HL, Hale MF, Sidhu R, et al. Magnetically assisted capsule endoscopy
in suspected acute upper GI bleeding versus esophagogastroduodenoscopy
in detecting focal lesions. Gastrointest Endosc. 2019;90(3):430-439.
doi: 10.1016/j.gie.2019.04.248.
Xia J, Xia T, Pan J, Gao F, et al. Use of artificial intelligence for detection of
gastric lesions by magnetically controlled capsule endoscopy. Gastrointest
Endosc. 2021;93(1):133-139.e4. doi: 10.1016/j.gie.2020.05.027.
Disclosure: Nothing to disclose.
P1040
USEFULNESS OF ENDOSCOPIC DELIVERY METHOD FOR PATIENTS
WITH CAPSULE ENDOSCOPY STAGNATION IN THE STOMACH
A. Sumioka1
K. Yamashita1
, S. Oka2
, T. Kotachi1
, I. Hirata2, S. Iio2, A. Tsuboi1
, S. Tanaka1
, H. Tanaka1
,
1Hiroshima University Hospital, Endoscopy, Hiroshima, Japan,
2
Hiroshima University Hospital, Gastroenterology and Metabolism,
Hiroshima, Japan
Contact E-Mail Address: hikoaki3@hiroshima-u.ac.jp
Introduction: With the spread of capsule endoscopy (CE), screening tests
for the small-bowel can be performed with minimal invasiveness. However,
there are cases in which the entire small-bowel cannot be visualised
due to decreased peristalsis of the stomach. For such cases, we perform
delivery of CE by an endoscope.
Aims & Methods: We examined the usefulness of endoscopic delivery
method for patients with CE stagnation in the stomach. Among the 2,270
patients with small-bowel in whom CE was performed at our hospital from
January 2013 to January 2020, we included 29 consecutive patients (1% of
total CE) for whom it was not possible to observe the small-bowel due to
CE stagnation in the stomach at the time of the initial CE and they underwent
our endoscopic delivery method at a later date. The procedure of our
endoscopic delivery method involved taking the CE orally, grasping it at
the stomach with a retrieval net (Olympus Medical Systems Corp, Japan),
releasing it at the descending part of the duodenum, and inserting it to the
depth of the transverse part of the duodenum with water.
We examined the clinical features of the patients, total small-bowel visualization
rate, small-bowel lesion detection rate, indicated lesions for
treatment, and complications related to our endoscopic delivery method.
CE stagnation in the stomach was defined as a case in which the last site
reached during the battery time in the initial CE was the stomach. CE was
performed using a PillCam® SB2 or SB3 capsule (Covidien, Mansfield, MA,
USA).
Results: This study included 16 male and 13 female patients, with a mean
age of 69.3±8.4 years. Performance status was highest in 22 patients (75%)
with PS0, and the body mass index was highest in 16 patients (55%), with
a normal range. A history of gastrointestinal surgical resection was observed
in 11 patients (38%), and the most concomitant disease was neurological
disease in 11 patients (38%). Total small-bowel observation rate by
our endoscopic delivery method was 67% (19/29), and CE reached the terminal
ileum in all patients. The incidence of the history of gastrointestinal
surgical resection in the total small-bowel non-observation group was significantly
higher than that in the total small-bowel observation group. The
small-bowel lesion detection rate by our endoscopic delivery method was
55% (16/29 patients), including angioectasia (6 patients, 21%), tumors
(5 patients, 17%), small-bowel inflammation (4 patients, 14%), and portal
hypertensive enteropathy (1 patient, 4%). Among them, the indicated
lesions for treatment were as follows: angioectasia in 3 patients, diffuse
large B-cell lymphoma in 1 patient, follicular lymphoma in 1 patient, and
small-bowel polyps in 1 patient. There were no complications associated
with our endoscopic delivery method.
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