Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Changes in Indications and Diagnostic Rates of Capsule Endoscopy in a Single Center

단일 센터에서 캡슐내시경 검사의 적응증과 성적의 변화

  • Lee, Tae-Hee (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Kim, Jin-Oh (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Kim, Hyun-Gun (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Choi, Hyun-Sook (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Kim, Wan-Jung (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Cho, Young-Kwan (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Cho, Won-Young (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Ko, Bong-Min (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Cho, Joo-Young (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Lee, Joon-Seong (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Lee, Moon-Sung (Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • 이태희 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 김진오 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 김현건 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 최현숙 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 김완중 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 조영관 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 조원영 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 고봉민 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 조주영 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 이준성 (순천향대학교 의과대학 내과학교실 소화기연구소) ;
  • 이문성 (순천향대학교 의과대학 내과학교실 소화기연구소)
  • Received : 2009.12.26
  • Accepted : 2010.05.02
  • Published : 2010.06.30
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Abstract

Background/Aims: The aim of this study was to investigate changes with time in indications for capsule endoscopy examinations (CEs) and diagnostic rates. Methods: We retrospectively reviewed medical records of 425 CEs (417 patients), which were done for several different indications between March 2003 and May 2009. Indications, bowel cleansing, complete CEs, and diagnostic rates were compared between the first half (2003~2005) and the second half (2006~2009) of the study period. Results: Overt bleeding and occult bleeding, respectively, accounted for 31% and 5.8% in the first half; and 45.4% and 12.4% in the second half. The differences were significant (p<0.05). Other indications were significantly decreased in the second half compared to the first half (29.6% and 7.7% respectively). Bowel cleansing was considered "adequate" in 48% in the first half vs. 61.6% in the second half (p<0.05). No significant difference was found in complete CE rates. There was a significant difference in diagnostic rates between the first half and the second half (23.8% and 43.9%, respectively). Conclusions: Cumulative experience and knowledge with CEs has led to an increased number of CEs for obscure bleeding and a decreased number of CEs for other indications in which the role of CEs was unclear. Improved diagnostic rates of CEs were accompanied by these changes in CEs indications.

목적: 단일 센터에서 6년간 시행한 캡슐내시경 검사의 시간에 따른 적응증과 진단율의 변화를 알아보기로 했다. 대상 및 방법: 2003년 3월부터 2009년 5월까지 다양한 이유로 시행된 425예의 캡슐내시경 결과(417명 환자)를 의무기록과 캡슐내시경 데이터베이스를 이용하여 전반기(2003년~2005년)와 후반기(2006년~2009년)로 나누어 캡슐내시경 검사의 적응증, 소장 정결도, 완전 검사율 및 양성 진단율을 후 향적으로 비교 분석하였다. 결과: 전 후반기간의 캡슐내시경의 적응증에서 유의한 변화는 현성 출혈과 잠복 출혈이 전반기에 각각 31%, 5.8%에서 후 반기에 45.4%, 12%로 증가한 반면 기타 적응증은 전반기의 29.6%에서 후반기의 7.7%로 감소하였다. 소장 정결도는 전반기에는 48%에서 양호한 반면 후반기에는 61.6%에서 양호하여 후반기에 소장 정결도가 유의하게 향상되었다. 그러나 전, 후반기간에 완전 검사율은 유의한 차이를 보이지 않았다. 캡슐내시경 검사의 양성 진단율은 전반기에는 23.8%이었고 후반기에는 43.9%로 후반기에 유의하게 향상되었다. 결론: 캡슐내시경 검사의 시간에 따른 적응증 변화로는 유용성과 타당성이 확실하지 않은 기타 적응증은 감소한 반면 유용성과 타당성이 입증된 원인불명의 위장관 출혈은 증가하였다. 또한 소장 정결도는 향상되어 시간에 따른 캡슐내시경 검사의 진단율이 향상되었다.

Keywords

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