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【medical-news】胶囊内镜可能漏掉术后克隆氏病的
NEW YORK (Reuters Health), Jul 10 - During six-month evaluation of patients treated surgically for Crohn's disease, a French research team has found that wireless capsule endoscopy (WCE) detects lesions that are beyond the scope of ileocolonoscopy. However, some of the lesions in the neoterminal ileum, which may bear more clinical significance than other intestinal lesions, are missed by WCE but identified by ileocolonoscopy.
"At the present time, it seems that WCE cannot systematically replace ileocolonoscopy in the regular management of patients after surgery," Dr. J. F. Colombel and associates say in their report, published in the July issue of Gut.
Severe lesions in the neoterminal ileum are currently the best predictor of early relapse following surgery, helping to determine best treatment of patients with Crohn's, according to Dr. Colombel, from the University Hospital in Lille, and other members of the team.
Ileocolonoscopy is considered the "gold standard technique" for investigation of the neointimal ileum. But compared with ileocolonoscopy, WCE is a less invasive procedure that does not require sedation, can visualize the full length of the small bowel, is capable of identifying small lesions, and is well tolerated by patients, the investigators note.
However, they add, prospective studies comparing the two methodologies for follow-up of postsurgical Crohn's disease have not been conducted. Their goal was to fill that gap.
Their study included 31 patients who had undergone an ileocolonic resection. About six months later, the subjects underwent capsule endoscopy using the Given M2A capsule (Given Imaging, Maison-Laffitte, France), with recording of capsule video film, followed one week later by ileocolonoscopy.
Two investigators interpreted WCE video films, which required a mean duration of 54 minutes, compared with 25 minutes for interpreting ileocolonoscopy.
Altogether, 21 (68%) of the patients had a recurrence in the distal ileum. Ileocolonoscopy identified 19 patients with lesions, while two were detected only with WCE. For WCE-detected lesions observed by both observers, the sensitivity was 76%, compared with 90% for ileocolonoscopy, and specificities were 91% and 100%, respectively
The two observers detected lesions by WCE in the small intestine that were outside the scope of conventional ileocolonoscopy in 66% and 72% of patients.
Dr. Colombel and associates note that the clinical significance of these previously undetected lesions remains unknown, and they therefore recommend further prospective studies with more prolonged follow-up.
Last Updated: 2006-07-07 14:44:22 -0400 (Reuters Health) Capsule endoscopy may miss postop recurrence of Crohn's disease
NEW YORK (Reuters Health), Jul 10 - During six-month evaluation of patients treated surgically for Crohn's disease, a French research team has found that wireless capsule endoscopy (WCE) detects lesions that are beyond the scope of ileocolonoscopy. However, some of the lesions in the neoterminal ileum, which may bear more clinical significance than other intestinal lesions, are missed by WCE but identified by ileocolonoscopy.
对术后克隆氏病的6个月的随访中，法国研究人员发现胶囊内镜可以发现回盲镜发现不了的病变，但是，对于回肠末端的病变，也就是临床意义最大的那部分，胶囊内镜容易漏诊，但是回盲镜可以发现。
"At the present time, it seems that WCE cannot systematically replace ileocolonoscopy in the regular management of patients after surgery," Dr. J. F. Colombel and associates say in their report, published in the July issue of Gut.
J.F. Colombel在7月份的杂志《胃肠》中的文章说：“目前看来，胶囊内镜尚不能全面取代回盲镜进行术后的复查”。
Severe lesions in the neoterminal ileum are currently the best predictor of early relapse following surgery, helping to determine best treatment of patients with Crohn's, according to Dr. Colombel, from the University Hospital in Lille, and other members of the team.
回肠末端的严重病变是克隆氏病术后复发的最佳指标，可以决定病人的最佳治疗方式。
Ileocolonoscopy is considered the "gold standard technique" for investigation of the neointimal ileum. But compared with ileocolonoscopy, WCE is a less invasive procedure that does not require sedation, can visualize the full length of the small bowel, is capable of identifying small lesions, and is well tolerated by patients, the investigators note.
在末端回肠的检查中，回盲镜被认为是金标准。胶囊内镜更加无创，不需要麻醉，可以看到小肠的全长，可以发现小病灶，病人耐受性更好。
However, they add, prospective studies comparing the two methodologies for follow-up of postsurgical Crohn's disease have not been conducted. Their goal was to fill that gap.
但是他们强调，目前还没有两种检查方法的系统性前瞻性研究。他们的研究目的就是填补这一空白。
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作者:admin@医学,生命科学 2010-09-29 05:11
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