Efficacy and safety of a capsule endoscope delivery device in children

Abstract

Objectives This multicenter, cross-sectional study aimed to elucidate the efficacy and safety of the AdvanCE capsule endoscope delivery device for children in Japan. Methods The present study analyzed 183 cases of small bowel capsule endoscope (SBCE) insertion performed using the AdvanCE in 154 patients aged less than 18 years at participating institutions between 2013 and 2017. Statistical analyses were conducted to identify factors contributing to the completion rate for the entire small intestine examination, small intestine transit time, adverse events and technical issues. Results The commonest reason for using the AdvanCE was the patient’s inability to swallow the SBCE, which was attributed to young age. SBCE was successfully delivered into the stomach or duodenum in 180 cases and was placed in the duodenum in 90% patients. In 89% patients, the entire small intestine was completely examined, and in 63% patients, findings leading to a new diagnosis or involving changing or maintaining the treatment strategy were obtained. No severe adverse events were observed; however, mild adverse events were observed in 35% patients. No factors considerably contributed to the completion rate for the entire small intestine examination or small intestine transit time and onset of technical issues. The factors that contributed to mild adverse events included intravenous anesthesia, technical issue, and absence of prior insertion of a patency capsule using the AdvanCE. Conclusion The AdvanCE is well tolerated and effective for children.

Safety and efficacy of the endoscopic delivery of capsule endoscopes in adult and pediatric patients: Multicenter Japanese study (AdvanCE‐J study)

“…[2][3][4][5] A multicenter, cross-sectional study including 183 patients aged <18 years demonstrated the successful delivery of SBCEs into the duodenum in 90% of patients without severe complications, with exceptions including an inability to deliver the capsule through the pharynx (n = 2) or the pylorus (n = 1). 6 Simon et al 7 reported a severe complication: small bowel perforation distal to the gastrojejunal anastomosis caused by AdvanCEbased delivery.…”

“…In such cases, endoscopic capsule placement is available using the AdvanCE delivery device (US Endoscopy Inc., Mentor, OH, USA), polypectomy snares, Roth nets, etc 2–5 . A multicenter, cross‐sectional study including 183 patients aged <18 years demonstrated the successful delivery of SBCEs into the duodenum in 90% of patients without severe complications, with exceptions including an inability to deliver the capsule through the pharynx ( n = 2) or the pylorus ( n = 1) 6 . Simon et al 7 .…”

Causes of Melena and Effective Examination Strategies in Children

“…By contrast, the European Society of Gastrointestinal Endoscopy guidelines clearly state that the prior use of patency capsule is not required for obscure gastrointestinal bleeding ( 21 ). In addition, in younger children who cannot swallow or in patients with dysphagia, EGD guidance is required for the insertion of the capsule endoscope and patency capsule ( 22 ). In such cases, EGD must be performed twice, and its invasiveness should be considered.…”

Applications of Microwaves in Medicine

“…In 2009, it was approved by the FDA. Over the years, its safety and effectiveness have been investigated extensively [15], [16], [17]. Wireless capsule endoscopy eliminates the need of using optical fibers or a CMOS camera via a tethered endoscope, which is bulky and often requires general anesthesia to examine the gastrointestinal (GI) tract.…”