Clinical Efficiency and Safety of Magnetic-Controlled Capsule Endoscopy for Gastric Diseases in Aging Patients: Our Preliminary Experience

Dig Dis Sci. 2019 Oct;64(10):2911-2922. doi: 10.1007/s10620-019-05631-5. Epub 2019 Apr 29.

Abstract

Background: The elderly assess higher incidence of gastric diseases and may meet challenges and contraindications when flexible esophagogastroduodenoscopy intubating. Magnetic-controlled capsule endoscopy (MCE) is declared as a promising alternative, but its applications in elderly population do not attach enough importance.

Aims: To explore MCE's efficiency and safety in the elderly.

Methods: A single-center retrospective study has been conducted. Data from the elderly group (>65 year-old) who underwent MCE examination, including indications, MCE outcomes, gastric conditions, evaluations from MCE manipulators and endoscopists, subjective discomforts, adverse events, etc., had been collected, then analyzed, and compared with the ones from the middle-aged group (>40, ≤ 65 year-old).

Results: During April 2015 and September 2018, 98 elderly patients and 72 middle-aged patients underwent MCE examination. In the elderly, the indications included poor physical condition (28.6%), severe angiocardiopathy (39.8%), EGD rejection (13.3%), severe respiratory disorder (8.2%), craniocerebral injury (8.2%), and allergy to anesthetics (2.0%). Rate of complete gastric observation and positive finding were 98.0% and 72.4% (vs. middle-aged group, 94.4%, 56.9%, P = 0.220, 0.035), and gastric conditions showed relatively inferior. Gastric preparation and MCE procedure were generally tolerated, but three elderly patients (3.1%) experienced capsule blockage in stomach.

Conclusions: Our preliminary data support that MCE offers considerable benefit and is general safe for the elderly. We hope such data promote greater awareness of innovative attempts for the specific elderly, and expect multi-center, large-scale trials with randomized controlled design bring optimized strategies for better gastric visibility, efficacy and lower potential risk.

Keywords: Diagnostic efficiency; Gastric disease; Magnetic-controlled capsule endoscopy; Safety evaluation; The elderly.

MeSH terms

  • Age Factors
  • Aged
  • Capsule Endoscopy* / adverse effects
  • Capsule Endoscopy* / instrumentation
  • Capsule Endoscopy* / methods
  • China / epidemiology
  • Female
  • Geriatric Assessment / methods
  • Humans
  • Magnets*
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Reproducibility of Results
  • Retrospective Studies
  • Stomach / diagnostic imaging*
  • Stomach Diseases / diagnosis*
  • Stomach Diseases / epidemiology
  • Treatment Outcome