Gut Liver.  2017 Jan;11(1):62-72. 10.5009/gnl16015.

Effectiveness of Capsule Endoscopy Compared with Other Diagnostic Modalities in Patients with Small Bowel Crohn’s Disease: A Meta-Analysis

Affiliations
  • 1National Evidence-based Healthcare Collaborating Agency, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. shimkn@ewha.ac.kr
  • 4Department of Nursing Science, College of Nursing, Gachon University, Incheon, Korea. sunarea87@gachon.ac.kr

Abstract

BACKGROUND/AIMS
As a result of the rapid development of medical diagnostic tools, physicians require concrete evidence to evaluate the effectiveness of the tools. We aimed to investigate the effectiveness and additional diagnostic benefits of capsule endoscopy (CE) in patients with small bowel Crohn's disease (CD).
METHODS
We performed a systematic search of databases, including MEDLINE, EMBASE, and the Cochrane Library, as well as eight domestic databases. Two reviewers independently screened all references. Diagnostic data from the studies were collected, and a meta-analysis was performed.
RESULTS
Twenty-four studies were included. In cases of suspected CD, CE demonstrated a superior diagnostic yield compared with small bowel follow-through (SBFT) and enteroclysis (EC); however, there was no difference compared with computed tomography enterography or magnetic resonance enterography. In cases with established CD, CE demonstrated a higher diagnostic yield only compared with EC. In the detection of terminal ileum lesions, CE exhibited a significantly increased detection rate compared with ileoscopy.
CONCLUSIONS
The findings of our meta-analysis indicate that CE is superior to SBFT and EC in the evaluation of suspected CD cases. CE is also a more effective diagnostic modality in patients with established CD compared with EC.

Keyword

Capsule endoscopy; Diagnostic yield; Meta-analysis; Intestine; small; Crohn disease

MeSH Terms

*Capsule Endoscopy
Crohn Disease/*diagnosis/diagnostic imaging/pathology
Endoscopy, Digestive System
Humans
Intestine, Small/diagnostic imaging/*pathology
Magnetic Resonance Imaging
Tomography, X-Ray Computed
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