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Detachable String MCE for Upper Gastrointestinal Tract and Small Bowel

Not Applicable
Conditions
Capsule Endoscopy
Interventions
Device: DS-MCE
Registration Number
NCT04329468
Lead Sponsor
Zhuan Liao
Brief Summary

This study aims to evaluate the feasibility and safety of DS-MCE with a novel way for complete examination in UGI tract and small bowel, compared with EGD.

Detailed Description

Magnetically controlled capsule endoscopy (MCE) has been widely used in clinical practice for upper gastrointestinal (UGI) tract and Small Bowel. However, the complete visualization of UGI tract still present challenges due to rapid transit through esophagus and duodenum, although technical improvements of MCE are helpful.

Detachable String MCE (DS-MCE) can control the movement of MCE through the string and MCE can start next examination after string detachment, which was proved to be an effective and safe method for complete viewing of the esophagus and stomach. In order to improve the duodenum visualization, endoscopist separate MCE from the string after finishing UGI examination so that can inspect the esophagus, stomach and duodenum under the string and magnetic field control.

This is a prospective, single-centered, self-controlled pilot study. Subjects with or without digestive symptoms receiving UGI endoscopy will be enrolled to take DS-MCE and conventional esophagogastroduodenoscopy (EGD) within 48h successively.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
25
Inclusion Criteria
  1. Adult patients aged 18 to 80
  2. With or without gastrointestinal complaints
  3. Scheduled to undergo a capsule endoscopy for both stomach and small bowel
  4. Signed the informed consents before joining this study
Exclusion Criteria
  1. Pacemakers or electromedical devices implanted which are incompatible with magnetic field;
  2. Suspected or known gastrointestinal stenosis, obstruction or other known risk factors for capsule retention;
  3. Scheduled magnetic resonance imaging examination before excretion of capsule;
  4. Pregnancy or suspected pregnancy;
  5. Any contraindications about EGD.
  6. Other circumstances that doctors consider inappropriate for the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
DS-MCE examinationDS-MCESubjects with or without digestive symptoms will be enrolled to take DS-MCE and conventional esophagogastroduodenoscopy (EGD) within 48h successively.
Primary Outcome Measures
NameTimeMethod
Success rate of UGI and small-bowel examinationup to 2 weeks

The feasibility of DS-MCE examination with a novel way is evaluated by the technical success rate, a composite outcome including the successful separation of the string and MCE, repeat viewing of esophagus, stomach and duodenum, and complete small-bowel examination.

Secondary Outcome Measures
NameTimeMethod
Diagnostic accuracyup to 2 weeks

The diagnostic accordance rate, sensitivity and specificity of lesions detected by DS-MCE compared with EGD.

Safety of DS-MCE procedure: presence of any adverse events during DS-MCE procedure will be recordedup to 2 weeks

The presence of any adverse events during DS-MCE procedure will be recorded.

Detection rate of Z-line, duodenal papilla and pyloric retrograde viewup to 2 weeks

The detection means that at least one image of anatomical structure was obtained.

Circumferential visualization of the Z-line and duodenal papillaup to 2 weeks

It is defined by quadrants as follows: less than 2 quadrants (\< 50%) observed; at least 2 quadrants (50%-75%) observed; at least 3 quadrants (\>75%) observed; and entire structure (100%) observed.

Cleansing level of Z-line and duodenal papilla areaup to 2 weeks

The effect of bubbles/saliva on the appearance of the Z line or duodenal papilla area was both scored as follows: 0=no interference by bubbles/saliva;1=minor interference of bubbles/saliva; 2=major interference of bubbles/saliva.

Visualization level of stomachup to 2 weeks

Visualization level of gastric primary anatomic landmarks: cardia, fundus, body, angulus, antrum and pylorus. (good, \>75% of mucosa was observed; moderate, 50% to 75% was observed; poor, \<50% of the gastric mucosa was observed)

Examination time of esophagus, stomach, duodenum and small bowelup to 2 weeks

Record the time taken to finish examination in different digestive part.

Pyloric transit timeup to 2 weeks

Record the time from completion of the gastric examination to the capsule entering the duodenum.

Discomfort scores associated with DS-MCEup to 2 weeks

Discomfort caused by the string, swallowing the DS-MCE, pulling the capsule up or down, and pulling the string out were on a scale from 0 to 3 (0=none;1=mild/minimal; 2=moderate; and 3=severe/very difficult) according to the Ramirez system. Overall discomfort was scored on a scale of 0 to 10 (0=no discomfort; 10=the overall discomfort of EGD) according to our previous system.

Image quality scoresup to 2 weeks

Assess Image quality grade ranged from 1 to 10 (1, the worst quality; 10, the quality of the best image captured by EGD).

Detection rate of lesionsup to 2 weeks

The detection rate of lesions in different digestive part (esophagus, stomach, duodenum, jejunoileum) found by MCE.

Trial Locations

Locations (1)

Changhai Hospital

🇨🇳

Shanghai, China

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