Objective: To clarify the feasibility and safety of magnetically guided capsule endoscopy (MGCE) in minors. Methods: A descriptive cohort study was carried out to retrospectively collect the data of minors (<18 years) who underwent MGCE in Ruijin Hospital from April 2015 to October 2018. Exclusion criteria: patients with dysphagia, obvious gastrointestinal bleeding, diagnosed or suspected gastrointestinal obstruction, or congenital gastrointestinal malformations or intestinal fistula; patients with previous bowel surgery, or in poor general condition; patients with implants; pregnant patients; patients with incomplete data or without data. A total of 218 patients, including 122 males and 96 females, with mean age of (12.0±3.1) (5-17) years and 236 times of examination were included. The capsule size of the Ankon MGCE system was 11.8 mm×27 mm, taking two pictures per second, with a viewing angle of 140 degrees. Data of gastric visualization (0% to 100%), gastric cleanliness (satisfactory cleanliness was defined as a clear display of the gastric mucosa; the effect of bubbles or mucus on the visual field was negligible, or the gastric mucosa was slightly blurred; a small amount of air bubbles or mucus affected slightly the field of view), gastric or small bowel examination time, lesion detection rate, etc. were recorded. All the patients were followed up for 2 weeks to confirm capsule excretion and to record adverse events. Results: A total of 202 patients (217 times) completed gastric examination and 112 patients (125 times) completed small bowel examination. The median gastric visualization of cardia, fundus, body, angulus, antrum and pylorus was 100%, 90% (75%,100%), 100% (80%,100%), 100%, 100%, and 100%, respectively. The cleanliness of the gastric cardia, fundus, body, angle, antrum, and pylorus was assessed to be satisfactory in 100.0%, 76.5% (153/200), 92.5% (185/200), 97.5% (195/200), 99.5% (199/200), and 100.0% of patients, respectively. In 202 patients undergoing gastric examination, the median gastric exanimation time was 10.5 (7.3, 13.9) minutes. In 112 patients undergoing small bowel examination, the median gastric transit time was 51.5 (20.6, 112.0) minutes and the median small bowel transit time was 232.4 (181.8, 321.6) minutes. The small bowel transit rate was 91.1% (102/112). The lesion detection rates of stomach, duodenum and jejunoileum were 18.8% (38/202), 8.1% (10/124) and 26.8% (30/112) respectively. No complications or adverse events occurred. Conclusion: MGCE is feasible and safe to detect both gastric cavity and small bowel in minors.
目的： 探讨磁控胶囊内镜应用于未成年人消化道检查中的可行性和安全性。 方法： 采用描述性病例系列研究方法。回顾性收集2015年4月至2018年10月期间，在上海交通大学附属瑞金医院行磁控胶囊内镜检查的<18周岁的未成年患者病例资料。排除吞咽困难、明显的消化道出血、已知或怀疑消化道梗阻、畸形、瘘管、既往肠道手术、一般情况差、体内有植入物、怀孕者及检查录像和报告资料缺失者后，共218例患者共计236次检查纳入本研究。男性122例，女性96例，年龄为（12.0±3.1）（5~17）岁。全组共计202例（217例次）完成胃部检查，112例（125例次）完成小肠检查。检查所用的磁控胶囊内镜系统（中国安翰科技股份有限公司）采用胶囊机器人大小为11.8 mm×27.0 mm，拍摄频率为2张照片/min，拍摄视角为140°。记录磁控胶囊内镜检查的胃黏膜观察率（0%~100%）和胃清洁度（满意清洁度定义为胃黏膜显示清晰，气泡或黏液对视野的影响几乎可忽略不计，或胃黏膜显示稍模糊，少量气泡或黏液影响视野）、以及胃或小肠的检查时间，并观察磁控胶囊内镜对胃及小肠病变的检出情况。检查后随访2周，确定胶囊是否排出体外，记录并发症及不良事件。 结果： 贲门、胃底、胃体、胃角、胃窦和幽门6个部位的中位胃黏膜观察率M（P(25)，P(75)）分别为100%、90%（75%，100%）、100%（80%，100%）、100%、100%和100%。而贲门、胃底、胃体、胃角、胃窦和幽门达到满意胃清洁度的患者比例分别为100.0%、76.5%（153/200）、92.5%（185/200）、97.5%（195/200）、99.5%（199/200）和100.0%。共202例完成胃部检查，胃检查中位时间为10.5（7.3，13.9）min。共112例完成小肠检查，其胃通过中位时间为51.5（20.6，112.0）min，小肠通过中位时间为232.4（181.8，321.6）min；小肠通过率为91.1%（102/112）。胃部、十二指肠、空肠回肠阳性病灶检出率分别为18.8%（38/202）、8.1%（10/124）和26.8%（30/112）。无并发症及不良事件发生。 结论： 磁控胶囊内镜应用于未成年人消化道检查安全可行。.
Keywords: Adolescent; Child; Endoscopy, magnetically guided capsule; Feasibility studies.