期刊
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
卷 52, 期 8, 页码 840-845出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/00365521.2017.1310289
关键词
Colon capsule endoscopy; endoscopy; colonoscopy; second-generation colon capsule; Crohn's disease; postoperative management
资金
- Given Imaging/Medtronic (Minneapolis, MN, USA)
Background: Patients are at increased risk of disease recurrence after surgical treatment of Crohn's disease. Endoscopic detection of postoperative, ileo-colonic inflammation is well established, but the potential of pan-intestinal endoscopy is yet unknown.Methods: This prospective multicenter pilot study assessed the value of pan-intestinal capsule endoscopy using a colon capsule endoscope for the detection of inflammatory recurrence of Crohns disease. Patients who had been operatively treated for Crohns disease were included. Colon capsule endoscopy was performed 4-8 weeks (d1) and 4-8 months (d2) postoperatively together with ileo-colonoscopy at d2 using a modified Ruttgeerts index for evaluating disease activity.Results: Twenty-two patients were included into this study. At d1, significant disease activity (Ruttgeerts index 2) was detected in 3/16 (19%) of the patients. At d2, half of the patients (6/12) showed active disease, whereas ileo-colonoscopy revealed significant inflammation in 5/15 (33%). All patients rated as having active disease by ileo-colonoscopy had been revealed by PICE as well. These findings influenced the medical treatment in every case.Conclusion: Pan-intestinal capsule endoscopy seems to be feasible in the postoperative surveillance of Crohn's disease. Disease activity is reliably detected. Especially, the findings in the small bowl might be a significant advantage in comparison to ileo-colonoscopy, as they can have significant impact on clinical management. Further studies with a larger number of patients are needed to confirm these findings and might lead to a replacement of the flexible ileo-colonoscopy with pan-intestinal capsule endoscopy in this indication in the future.
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