The yield and safety of string capsule endoscopy in patients with dysphagia

Nooman Gilani, Sally Stipho, Masud S. Shaukat, Rodney Akins, Francisco C Ramirez

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Dysphagia is a contraindication for the use of conventional capsule endoscopy (CE). Because string CE (SCE) allows for the immediate retrieval of the device, it eliminates the risk of capsule retention. Objective: To assess the yield and safety of SCE in patients with dysphagia. Design: Comparative study of SCE and EGD. Setting: Phoenix Veteran Affairs Medical Center. Patients and Interventions: Patients with dysphagia underwent SCE and EGD. Results: In 40 patients with dysphagia, the EGD findings were normal in 13 (32.5%); Schatzki's ring in 10 (25%); esophageal tumors in 9 (22.5%), with 1 of these having 2 separate and distinct malignancies; erosive esophagitis in 4 (10%); strictures in 2 (5%); and a web and large esophageal varices in 1 patient each (2.5%). The sensitivity of SCE for diagnosing anatomic pathology as the likely cause of dysphagia was 92.9%, with a specificity of 92.3%, a positive predictive value of 96.3%, and negative predictive value of 85.7%. The overall agreement between SCE and EGD was 92.7% and the kappa index was 0.83. There were no complications with either procedure. There was no case of capsule retention. The SCE recording time was 385.8 seconds; 77.5% patients preferred SCE to EGD. Conclusions: (1) SCE was safe, well tolerated, and accurate for the diagnosis of pathology responsible for dysphagia; (2) SCE was preferred to EGD by more than three fourths of patients; (3) SCE can be safely performed in patients with dysphagia.

Original languageEnglish (US)
Pages (from-to)1091-1095
Number of pages5
JournalGastrointestinal Endoscopy
Volume66
Issue number6
DOIs
StatePublished - Dec 2007
Externally publishedYes

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Capsule Endoscopy
Deglutition Disorders
Safety
Capsules
Pathology
Esophageal and Gastric Varices
Esophagitis
Veterans
Neoplasms
Pathologic Constriction
Equipment and Supplies

ASJC Scopus subject areas

  • Gastroenterology

Cite this

The yield and safety of string capsule endoscopy in patients with dysphagia. / Gilani, Nooman; Stipho, Sally; Shaukat, Masud S.; Akins, Rodney; Ramirez, Francisco C.

In: Gastrointestinal Endoscopy, Vol. 66, No. 6, 12.2007, p. 1091-1095.

Research output: Contribution to journalArticle

Gilani, Nooman ; Stipho, Sally ; Shaukat, Masud S. ; Akins, Rodney ; Ramirez, Francisco C. / The yield and safety of string capsule endoscopy in patients with dysphagia. In: Gastrointestinal Endoscopy. 2007 ; Vol. 66, No. 6. pp. 1091-1095.
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abstract = "Background: Dysphagia is a contraindication for the use of conventional capsule endoscopy (CE). Because string CE (SCE) allows for the immediate retrieval of the device, it eliminates the risk of capsule retention. Objective: To assess the yield and safety of SCE in patients with dysphagia. Design: Comparative study of SCE and EGD. Setting: Phoenix Veteran Affairs Medical Center. Patients and Interventions: Patients with dysphagia underwent SCE and EGD. Results: In 40 patients with dysphagia, the EGD findings were normal in 13 (32.5{\%}); Schatzki's ring in 10 (25{\%}); esophageal tumors in 9 (22.5{\%}), with 1 of these having 2 separate and distinct malignancies; erosive esophagitis in 4 (10{\%}); strictures in 2 (5{\%}); and a web and large esophageal varices in 1 patient each (2.5{\%}). The sensitivity of SCE for diagnosing anatomic pathology as the likely cause of dysphagia was 92.9{\%}, with a specificity of 92.3{\%}, a positive predictive value of 96.3{\%}, and negative predictive value of 85.7{\%}. The overall agreement between SCE and EGD was 92.7{\%} and the kappa index was 0.83. There were no complications with either procedure. There was no case of capsule retention. The SCE recording time was 385.8 seconds; 77.5{\%} patients preferred SCE to EGD. Conclusions: (1) SCE was safe, well tolerated, and accurate for the diagnosis of pathology responsible for dysphagia; (2) SCE was preferred to EGD by more than three fourths of patients; (3) SCE can be safely performed in patients with dysphagia.",
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