Esophageal Capsule Endoscopy vs. EGD for the Evaluation of Portal Hypertension: A French Prospective Multicenter Comparative Study

Lapalus, M. G.; Soussan, Emmanuel Ben; Gaudric, M; Saurin, Jean Christophe; D’Halluin, Pierre-Nicolas; Favre, Olivier; Filoche, B; Cholet, Franck; Leusse, A de; Antonietti, Michel; Gaudin, Jean-Louis; Sogni, P.; Héresbach, D.; Ponchon, T; Dumortier, Jérôme

doi:10.1038/ajg.2009.66

Cited by 54 publications

(38 citation statements)

References 24 publications

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“…Also, as in the Choe et al [21] study, we found that concordance rates on grading esophageal varices were excellent at 95% (κ = 0.91). These results are better than those reported by using endoscopy capsule for detection of esophageal varices [7][8][9] . With regards to erosive esophagitis diagnosed at upper endoscopy, E.G.…”

Section: Discussioncontrasting

confidence: 54%

“…Several studies have shown that ECE is safe and has an acceptable accuracy for the evaluation of esophageal varices and can be used as an alternative to EGD for the screening of portal hypertension, especially in patients unable or unwilling to undergo EGD [7,9] . Unsedated small-caliber transnasal esophagoscopy offers the possibility of efficient and accurate endoscopic assessment of the esophagus, with less cost and fewer risks compared with sedated upper endoscopy, and can be used as a method to screen for esophageal disease in a primary care population [11][12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

“…Over the last years, several noninvasive or minimally invasive methods have been proposed as alternatives to conventional EGD for the diagnosis of esophageal diseases, such as esophageal capsule endoscopy (ECE) and ultra-thin small caliber esophagoscopes [7][8][9][10][11][12] . Several studies have shown that ECE is safe and has an acceptable accuracy for the evaluation of esophageal varices and can be used as an alternative to EGD for the screening of portal hypertension, especially in patients unable or unwilling to undergo EGD [7,9] .…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Aedo

Zavala-González

Meixueiro-Daza

et al. 2014

WJGE

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AIM:To assess feasibility of unsedated esophagoscopy using a small-caliber disposable transnasal esophagoscopy and to compare its accuracy with standard endoscopy. METHODS:We prospectively included subjects who were referred for upper endoscopy. All subjects underwent transnasal endoscopy with E.G. Scan™. The disposable probe has a 3.6 mm gauge and at its distal end there is a 6 mm optical capsule, with a viewing angle of 125°. Patients underwent conventional endoscopy after the completion of E.G. Scan™. We describe the findings detected by the E.G. Scan™ and calculate the diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa index for esophageal diagnosis. RESULTS:A total of 96 patients (54 women), mean age of 50.12 years (14 to 79), were evaluated. In all cases we were able to perform esophagoscopy with E.G.Scan™. The average realization time was 5 min. A total of 58 alterations were detected in the esophagus, 49 gastric abnormalities and 13 duodenal abnormalities. We found that for esophageal varices, E.G. Scan™ has sensitivity, specificity and diagnostic accuracy of 95%, 97% and 97%, respectively. Kappa coefficients were 0.32 for hiatal hernia, 0.409 for erosive gastroesophageal reflux disease, 0.617 for Barrett's esophagus, and 0.909 for esophageal varices. CONCLUSION:Esophagoscopy with E.G. Scan™ is a well-tolerated, fast and safe procedure. It has an appropriate diagnostic accuracy for esophageal varices when compared with conventional endoscopy.

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Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Aedo

Zavala-González

Meixueiro-Daza

et al. 2014

WJGE

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“…A significant correlation has been found between capsule and standard endoscopy for the detection of varices. The sensitivity of capsule endoscopy ranged from 68% to 100% with a specificity ranging from 88% to 100% [49][50][51][52][53]. For the detection of large varices, the sensitivity was 78% with a specificity of 96% [52].…”

Section: Detection Of Varices and Prognostic Markers For Varicesmentioning

confidence: 99%

“…Among them, video capsule endoscopy appears to be a very promising tool for the detection of esophageal varices. Video capsule endoscopy has been compared to conventional upper endoscopy in several studies [49][50][51][52][53]. A significant correlation has been found between capsule and standard endoscopy for the detection of varices.…”

Section: Detection Of Varices and Prognostic Markers For Varicesmentioning

confidence: 99%

Prognostic Markers in Patients with Cirrhosis and Portal Hypertension Who Have Not Bled

et al. 2011

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Abstract. Prognostic markers of compensated cirrhosis should mainly investigate factors involved with progression to decompensation because death in cirrhosis is related with decompensation. Portal hypertension plays a crucial role in the pathophysiology of most complications of cirrhosis. Accordingly, HVPG monitoring has strong prognostic value. An HVPG 10 mmHg determines a significantly higher risk of developing decompensation. Esophageal varices also can develop when the HVPG is 10 mmHg, although an HVPG 12 mmHg is required for variceal bleeding to occur. Monitoring the changes induced by the treatment of portal hypertension on HVPG, provides strong prognostic information. In compensated cirrhosis hemodynamic response is appropriate when the HVPG decreased to < 10 mmHg or by > 10% from baseline, because the incidence of complications such as bleeding or ascites significantly decrease when these targets are achieved. Whether serum markers, such as the FibroTest, they, may be valuable to predict decompensation should be established. Transient Elastography is a promising technique that has shown an excellent accuracy to detect severe portal hypertension. However, whether it can adequately determine clinically significant portal hypertension, and risk of developing varices and decompensation, should be established. Magnetic Resonance Elastography is also promising.

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Capsule endoscopy for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis

Colli

Gana

Turner

et al. 2014

Cochrane Database of Systematic Reviews

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Background Current guidelines recommend performance of oesophago-gastro-duodenoscopy at the time of diagnosis of hepatic cirrhosis to screen for oesophageal varices. These guidelines require people to undergo an unpleasant invasive procedure repeatedly with its attendant risks, despite the fact that half of the people do not have identifiable oesophageal varices 10 years after the initial diagnosis of cirrhosis. Video capsule endoscopy is a non-invasive test proposed as an alternative method for the diagnosis of oesophageal varices. Objectives To determine the diagnostic accuracy of capsule endoscopy for the diagnosis of oesophageal varices in children or adults with chronic liver disease or portal vein thrombosis, irrespective of the aetiology. To investigate the accuracy of capsule endoscopy as triage or replacement of oesophago-gastro-duodenoscopy.

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Esophageal Capsule Endoscopy vs. EGD for the Evaluation of Portal Hypertension: A French Prospective Multicenter Comparative Study

Abstract: This large multicenter study confirms the safety and acceptable accuracy of ECE for the evaluation of esophageal varices. ECE might be proposed as an alternative to EGD for the screening of portal hypertension, especially in patients unable or unwilling to undergo EGD.

Cited by 54 publications

References 24 publications

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Prognostic Markers in Patients with Cirrhosis and Portal Hypertension Who Have Not Bled

Capsule endoscopy for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis

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