CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(02): E163-E171
DOI: 10.1055/a-1648-2238
Original article

Noncontact magnetically controlled capsule endoscopy for infection-free gastric examination during the COVID-19 pandemic: a pilot, open-label, randomized trial

Jia-Hui Zhu
1   National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Shanghai, China
,
Jun Pan
1   National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Shanghai, China
,
Xiao-Nan Xu
1   National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Shanghai, China
,
Ya-Wei Liu
2   Department of Gastroenterology, The First Medical Center of PLA General Hospital/Chinese PLA Postgraduate Military Medical School, Beijing, China
,
Yang-Yang Qian
1   National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Shanghai, China
,
Xi Jiang
1   National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Shanghai, China
,
Bin Jiang
1   National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Shanghai, China
,
Wei Zhou
1   National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Shanghai, China
,
En-Qiang Linghu
2   Department of Gastroenterology, The First Medical Center of PLA General Hospital/Chinese PLA Postgraduate Military Medical School, Beijing, China
,
Zhao-Shen Li
1   National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Shanghai, China
,
Zhuan Liao
1   National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Shanghai, China
› Institutsangaben

Abstract

Background and study aims Endoscopists have been at increased risk because of their direct contact with patients during the COVID-19 pandemic. For patients, being diagnosed with and monitored for gastrointestinal cancer and digestive diseases in timely fashion has been challenging, given pandemic-related adjustments in endoscopy departments. We developed a novel noncontact magnetically controlled capsule endoscopy (ncMCE) system in our medical center. In the current study, we aimed to evaluate the feasibility and safety of ncMCE for gastric examination.

Patients and methods Patients were randomly assigned to groups that received ncMCE or MCE in a 1:1 ratio from March 26, 2020 to April 26, 2020. Primary endpoints were feasibility assessed by completion rate (CR) and safety based on the occurrence of adverse events (AEs) including infection. Secondary endpoints included maneuverability of endoscopists, pre-procedure perception and post-procedure satisfaction of patients, gastric examination time (GET), and diagnostic yield (DY).

Results Forty patients were enrolled with 100 % CR in both groups without any AEs. Neither the endoscopist nor the patients were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 14 days after gastric examination. There were no significant differences in maneuverability (19.3 vs. 20.0, P = 0.179), pre-procedure perception (9 vs. 9, P = 0.626) and post-procedure satisfaction (45 vs. 44, P =  0.999), ord DY (20 % vs. 30 %, P = 0.465).

Conclusions ncMCE is a feasible and safe method of gastric examination, which has the potential to protect both medical staff and patients from COVID-19 infection while providing serving as an essential endoscopy service.

Supplementary material



Publikationsverlauf

Eingereicht: 03. März 2021

Angenommen: 17. August 2021

Artikel online veröffentlicht:
15. Februar 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Li Q, Guan X, Wu P. et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020; 382: 1199-1207
  • 2 Chiu PWY, Ng SC, Inoue H. et al. Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements). Gut 2020; 69: 991-996
  • 3 Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology 2020; 158: 1518-1519
  • 4 Lui TK, Leung K, Guo CG. et al. Impacts of COVID-19 pandemic on gastrointestinal endoscopy volume and diagnosis of gastric and colorectal cancers: a population-based study. Gastroenterology 2020; 159: 1164-1166. e3
  • 5 Perisetti A, Gajendran M, Boregowda U. et al. COVID-19 and gastrointestinal endoscopies: Current insights and emergent strategies. Dig Endosc 2020; 32: 715-722
  • 6 Liao Z, Hou X, Lin-Hu EQ. et al. Accuracy of magnetically controlled capsule endoscopy, compared with conventional gastroscopy, in detection of gastric diseases. Clin Gastroenterol Hepatol 2016; 14: 1266-1273.e1261
  • 7 Enns RA, Hookey L, Armstrong D. et al. Clinical practice guidelines for the use of video capsule endoscopy. Gastroenterology 2017; 152: 497-514
  • 8 MacLeod C, Wilson P, Watson AJM. Colon capsule endoscopy: an innovative method for detecting colorectal pathology during the COVID-19 pandemic?. Colorectal Dis 2020; 22: 621-624
  • 9 Rothe C, Schunk M, Sothmann P. et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med 2020; 382: 970-971
  • 10 Pan J, Li Z, Liao Z. Noncontact endoscopy for infection-free gastric examination during the COVID-19 pandemic. VideoGIE 2020; 5: 402-403.e401
  • 11 Liao Z, He S, Sha W. et al. Capsule endoscopy practice during the COVID-19 pandemic: Recommendations from the Capsule Endoscopy Group of the Chinese Society of Digestive Endoscopy. Endosc Int Open 2021; 9: E280-E283
  • 12 Jiang X, Pan J, Li ZS. et al. Standardized examination procedure of magnetically controlled capsule endoscopy. VideoGIE 2019; 4: 239-243
  • 13 Chai N, Mei Z, Zhang W. et al. Endoscopy works during the pandemic of coronavirus COVID-19: recommendations by the Chinese Society of Digestive Endoscopy. United European Gastroenterol J 2020; 8: 798-803
  • 14 Zhu SG, Qian YY, Tang XY. et al. Gastric preparation for magnetically controlled capsule endoscopy: A prospective, randomized single-blinded controlled trial. Dig Liver Dis 2018; 50: 42-47
  • 15 Cortegoso Valdivia P, Le Grazie M, Gaiani F. et al. Separated pathways in the endoscopy unit for COVID-19 patients. Gastrointest Endosc 2020; 92: 239
  • 16 Siddique SM, Sultan S, Lim JK. et al. Spotlight: COVID-19 PPE and Endoscopy. Gastroenterology 2020; 159: 759
  • 17 Soetikno R, Teoh AYB, Kaltenbach T. et al. Considerations in performing endoscopy during the COVID-19 pandemic. Gastrointest Endosc 2020; 92: 176-183
  • 18 de Franchis R, Eisen GM, Laine L. et al. Esophageal capsule endoscopy for screening and surveillance of esophageal varices in patients with portal hypertension. Hepatology 2008; 47: 1595-1603
  • 19 Eldridge SM, Chan CL, Campbell MJ. et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. Pilot Feasibility Stud 2016; 2: 64
  • 20 Gralnek IM, Hassan C, Beilenhoff U. et al. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic. Endoscopy 2020; 52: 483-490
  • 21 Wang D, Hu B, Hu C. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323: 1061-1069
  • 22 Moscola J, Sembajwe G, Jarrett M. et al. Prevalence of SARS-CoV-2 antibodies in health care personnel in the New York City Area. JAMA 2020; 324: 893-895
  • 23 Thompson CC, Shen L, Lee LS. COVID-19 in endoscopy: Time to do more?. Gastrointest Endosc 2020; 92: 435-439
  • 24 May A, Manner H, Schneider M. et al. Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAP-Plus Study). Endoscopy 2007; 39: 606-612
  • 25 Zagari RM, Eusebi LH, Rabitti S. et al. Prevalence of upper gastrointestinal endoscopic findings in the community: A systematic review of studies in unselected samples of subjects. J Gastroenterol Hepatol 2016; 31: 1527-1538
  • 26 Senapati S, Advincula AP. Telemedicine and robotics: paving the way to the globalization of surgery. Int J Gynaecol Obstet 2005; 91: 210-216
  • 27 de Jong MJ, van der Meulen-de Jong AE, Romberg-Camps MJ. et al. Telemedicine for management of inflammatory bowel disease (myIBDcoach): a pragmatic, multicentre, randomised controlled trial. Lancet 2017; 390: 959-968
  • 28 Calton B, Abedini N, Fratkin M. Telemedicine in the time of coronavirus. J Pain Symptom Manage 2020; 60: e12-14
  • 29 Zweig S. Patient-doctor telemedicine: virtual care in the era of COVID-19 and beyond. Mo Med 2020; 117: 175-176
  • 30 Yan B, Liu H, Yang YS. et al. The robot-assisted system YunSRobot for soft endoscopy: a trial of remote manipulation on simulation models. Zhonghua Nei Ke Za Zhi 2018; 57: 901-906
  • 31 Ching HL, Hale MF, McAlindon ME. Current and future role of magnetically assisted gastric capsule endoscopy in the upper gastrointestinal tract. Therap Adv Gastroenterol 2016; 9: 313-321
  • 32 Azman AS, Luquero FJ. From China: hope and lessons for COVID-19 control. Lancet Infect Dis 2020; 20: 756-757
  • 33 Swain P. At a watershed? Technical developments in wireless capsule endoscopy. . J Dig Dis 2010; 11: 259-265
  • 34 Ullah H, Gopalakrishnan Nair N, Moore A. et al. 5G Communication: An Overview of Vehicle-to-Everything, Drones, and Healthcare Use-Cases. IEEE Access 2019; 7: 37251-37268
  • 35 Hollander JE, Carr BG. Virtually perfect? Telemedicine for Covid-19. . N Engl J Med 2020; 382: 1679-1681