Kapselendoskopie in der Diagnostik von Dünndarmerkrankungen

1. Einleitung

Die Kapselendoskopie hat die Dünndarmdiagnostik revolutioniert, da erstmals ein nicht invasives Verfahren zur Verfügung steht, das eine endoskopische Beurteilung der Schleimhaut ermöglicht. Optimal ergänzt wurde der klinische Einsatz der Kapselendoskopie, als mit der Einführung der Doppelballonenteroskopie ein komplementäres endoskopisches Verfahren zur Verfügung stand, das auf nicht chirurgischem Weg den Zugang zu den tieferen Dünndarmabschnitten und damit die Probenentnahme und Durchführung therapeutischer Maßnahmen ermöglichte.

In das aktuelle Update wurden nur Veröffentlichungen in Journalen mit Gutachterverfahren einbezogen. Die Literatursuche erfolgte über Medline und PubMed. Die einzelnen Abschnitte wurden jeweils von einem der Autoren verfasst (siehe Anhang), die Empfehlungen von allen Autoren gemeinsam diskutiert und festgelegt. Die Klassifizierung der Evidenz erfolgte nach Oxford Centre of Evidence Based Medicine [1] ([Tab. 1]).

Tab. 1 Klassifizierung der Evidenz- und Empfehlungsgrade 1. Empfehlungsgrad Evidenzgrad Beschreibung A Ia „Evidenz” durch systematisches Review randomisierter kontrollierter Studien (RCT) Ib „Evidenz” durch eine geeignet geplante RCT Ic Alle-oder-Keiner-Prinzip B IIa „Evidenz” durch systematisches Review gut geplanter Kohortenstudien IIb „Evidenz” durch eine gut geplante Kohortenstudie/RCT mäßiger Qualität (z. B. < 80 % Follow-up) IIc „Evidenz” durch Outcome-Research-Studien IIIa „Evidenz” durch systematisches Review gut geplanter Fallkontrollstudien IIIb „Evidenz” durch eine Fallkontrollstudie C IV „Evidenz” durch Fallserien/Kohorten- und Fallkontrollstudien mäßiger Qualität D V Expertenmeinung ohne explizite kritische Bewertung oder basierend auf physiologischen Modellen, Laborforschungsresultaten oder „first principles”

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