nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»nogr-322Research ArticleХИРУРГИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯSURGICAL GASTROENTEROLOGYКАПСУЛЬНАЯ ЭНДОСКОПИЯ ТОНКОЙ КИШКИ: 10 ЛЕТНИЙ ОПЫТ В ЛАТВИИTHE SMALL BOWEL VIDEO CAPSULE ENDOSCOPY - TEN YEARS EXPERIENCE IN LATVIAРодинаЕ. ..RodinaJ. ..noemail@neicon.ruДеровсА. ..DerovsA. ..aleksejs.derovs@gastroenterologs.lvДероваЕ. ..DerovaJ. ..noemail@neicon.ruПокротниексЮ. ..PokrotnieksJ. ..noemail@neicon.ruРижская Восточная клиническая университетская больница; Рижский Университет им. СтрадыняРоссияRiga East Clinical University Hospital; Riga Stradins UniversityRussian FederationРижский Университет им. Страдыня; Латвийский Центр Морской МедициныРоссияRiga Stradins University; Latvian Maritime Medicine CenterRussian FederationРижский Университет им. Страдыня; Клиническая Университетская больница им. П. СтрадыняРоссияRiga Stradins University; Pauls Stradins Clinical University HospitalRussian Federation2016201120160113947Copyright © Родина Е..., Деровс А..., Дерова Е..., Покротниекс Ю..., 20162016Родина Е..., Деровс А..., Дерова Е..., Покротниекс Ю...Rodina J..., Derovs A..., Derova J..., Pokrotnieks J...Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/322

Введение. Видео капсульная эндоскопия (ВКЭ) является относительно новым, информативным и малоинвазивным эндоскопическим методом диагностики, которое позволяет обследовать слизистую оболочку тонкого кишечника. Цель работы. Клиническая оценка 10 летнего опыта ВКЭ в Латвии. Материалы и методы. Ретроспективный анализ данных ВКЭ, которая была проведена в двух Латвийских больницах на протяжении десяти лет. Для каждого пациента был заполнен специальный оригинальный протокол исследования с более чем 370 параметрами. Все данные были введены в базу данных с последующим статистическим анализом в программе SPSS ver.19. Результаты. В общей сложности было проведено 530 ВКЭ. По техническим причинам в базу были занесены данные о 421 пациенте. Из них 245 (58.2%) пациентов были женщины и 176 (41.8%) - мужчины. Возраст пациентов варьировал от 13 до 82 (в среднем 44.39 ± 16.36) лет. Наиболее распространенные индикации для проведения обследования были: болезнь Крона (26.1%), железодефицитная анемия неясного генеза (22.8%), хронические необъяснимые боли в животе (20.4%) и кровотечения из желудочно-кишечного тракта неясной локализации (17.1%). Находки ВКЭ были клинически значимыми для 255 (60.57%) пациентов, значимость находки была спорна в 152 (36.10%) и клинически незначительна в 14 (3.33%) случаях. Подготовка кишечника перед капсульной эндоскопией была выполнена по одной из четырех схем. Была выявлена положительная статистически значимая корреляция между схемами подготовки тонкого кишечника и уровнем чистоты слизистой оболочки (р = 0.03). Используя схемы с 2 или 4 литрами раствора полиэтиленгликоля очистка кишечника была значительно лучше. Региональные нарушения транзита наблюдались в 55 (13.1%) случаев. Положительная статистически значимая корреляция наблюдалась между наличием нарушений регионального транзита капсулы в участках кишечника без визуальных изменений / дефектов в слизистой оболочке и возрастом пациентов (р = 0.028). Выводы: ВКЭ является клинически значимым обследованием и позволяет изменять дальнейшую тактику лечения пациентам с болезнью Крона, кровотечением из желудочно-кишечного тракта неясной локализации, железодефицитной анемией неясного генеза и хроническими болями в животе неясного генеза. На сегодняшний день схемы с использованием 2 или 4 литров раствора полиетиленгликоля являются наиболее эффективными схемами подготовки кишечника перед ВКЭ. Нарушения регионального транзита капсулы в участках кишечника без визуальных изменений в слизистой оболочке чаще встречается у пожилых пациентов.

Introduction. Video capsule endoscopy (VCE) is relatively new, informative and minimally invasive endoscopic diagnostic method for assessment of the small bowel mucosa. Objective. To evaluate the clinical significance of ten years’ experience of VCE in Latvia. Materials and methods. A retrospective review of patients who underwent VCE between July 2006 and July 2016 was conducted. All patients had undergone previous negative endoscopic examinations before VCE. Special original study protocol with more than 370 parameters was fulfilled for each patient. All the data was entered into the database with consecutive statistical analysis using SPSS ver.19. Results. In total out of 530 VCE were performed, due to technical reasons 421 patients’ data were entered into the database. Out of these, 245 (58,2%) patients were females and 176 (41,8%) - males. Patients’ age was varied from 13 to 82 (mean 44.39 ± 16.36) years. VCE most common indications were: Crohn’s disease (26.1%), unclear iron deficiency anemia (22.8%), chronic unexplained abdominal pain (20.4%) and obscure bleeding from the digestive tract (17.1%). VCE findings were justified as clinically significant in 255 (60.57%) of cases. In 152 (36.10%) - findings were doubtful, and in 14 (3.33%) - clinically insignificant. Bowel preparation prior to capsule endoscopy was performed using one of the four schemes. Bowel cleanliness was statistically significantly better (p = 0.03) using 2 liters or 4 liters of polyethylene glycol-based electrolyte solution. Regional transit abnormalities (RTA) in 55 (13.1%) cases. Positive statistically significant correlation was observed between presence of RTA without changes / defects in the small bowel mucosa and patients age (p = 0.028). Conclusions: VCE is clinically significant examination in patients with Crohn’s disease, obscure bleeding from the digestive tract, unexplained anemia and chronic unexplained abdominal pain, which also allows changing the patient’s further treatment tactics. 2 liters and 4 liters of polyethylene glycol-based electrolyte solution are by far the most efficient bowel preparation schemes prior VCE. RTA is more common in the elderly patients.

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The authors declare that there are no conflicts of interest present.