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Repetitive Position Change Improves Gastric Cleanliness for Magnetically Controlled Capsule Gastroscopy

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Abstract

Background and Aims

Good gastric preparation is essential for magnetically controlled capsule gastroscopy (MCCG) examination. This study aims to determine if repetitive position change after dimethicone premedication could further improve gastric cleanliness for MCCG.

Methods

Consecutive patients referred for MCCG in our center from May 7 to May 31, 2018 were prospectively enrolled and randomized to undergo repetitive position change for 15 min (position change group) or not (conventional group) after ingesting dimethicone. Primary outcome was gastric cleanliness score and secondary outcomes were detection rate of positive findings, number of lesions per patient, gastric examination time, and safety of MCCG.

Results

Totals of 43 and 40 were included in the position change and conventional groups, respectively. Gastric cleanliness score in the position change group was significantly higher than in the conventional group (21.2 ± 1.0 vs. 18.6 ± 2.0, P  < 0.001), as was the proportion of acceptable gastric cleanliness (gastric cleanliness score ≥ 18) (100% vs. 72.5%, P  < 0.001). There was no statistical difference in detection rate of positive findings between the two groups (27.9% vs. 27.5%, P  = 0.97). In the position change group, the gastric examination time was significantly reduced (13.2 ± 4.0 vs. 15.3 ± 5.1, P = 0.043). No adverse events were observed.

Conclusions

Repetitive position change after dimethicone premedication significantly improves gastric cleanliness for MCCG examination.

Clinical Trial Registration ClinicalTrials.gov, ID: NCT03514966.

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Funding

This study is supported by grants from the National Natural Science Foundation of China (to Z. Liao, No. 81422010); Foundation for the Author of National Excellent Doctoral Dissertation of China (to Z. Liao, No. 201271); the Shuguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission (to Z. Liao, No. 15SG33); the Chang Jiang Scholars Program of Ministry of Education (to Z. Liao, No. Q2015190); and Shanghai Sailing Program (to J. Pan, No. 18YF1422800), China.

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Author notes

  1. Yuan-Chen Wang, Jun Pan and Xi Jiang have contributed equally to this work.

Authors and Affiliations

  1. National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China

    Yuan-Chen Wang, Jun Pan, Xi Jiang, Xiao-Ju Su, Wei Zhou, Wen-Bin Zou, Yang-Yang Qian, Yi-Zhi Chen, Xiao Liu, Jin Yu, Xiao-Nan Yan, An-Jing Zhao, Zhao-Shen Li & Zhuan Liao

Authors
  1. Yuan-Chen Wang
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  2. Jun Pan
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  5. Wei Zhou
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Contributions

Study concept and design (ZL); registration of the study (YCW, JP); conduct of the study (YCW, JP); acquisition of data (YCW, XJS, XJ, WBZ, YYQ, WZ, XL, JY, XNY, AJZ); analysis and interpretation of data (YCW, JP); drafting of the manuscript (JP); statistical analysis (YCW); critical revision of the manuscript for important intellectual content (ZL, ZSL); obtained funding (ZL, JP). All authors had access to the study data and reviewed and approved the final manuscript.

Corresponding author

Correspondence to Zhuan Liao.

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Conflicts of interest

The authors have no conflicts of interest or financial ties to disclose.

Electronic supplementary material

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Supplementary Figure S1.

Gastric preparation regimen. (TIFF 6025 kb)

Supplementary Figure S2.

Representative images showing the 4-point grading scale used to objectively describe the cleanliness of the stomach during magnetically controlled capsule gastroscopy. (A) Excellent, no adherent mucus and foam (score 4). (B) Good, mild mucus and foam but does not obscure vision (score 3). (C) Fair, considerable amount of mucus or foam present precluding a completely reliable examination (score 2). (D) Poor, large amount of mucus or foam residue needing water to clear it (score 1). (TIFF 5712 kb)

Supplementary Figure S3.

The images of primary landmarks in stomach. (A) Cardia. (B) Fundus. (C) Body. (D) Angulus. (E) Antrum. (F) Pylorus. (TIFF 16928 kb)

Supplementary Figure S4.

Typical findings by magnetically controlled capsule gastroscopy. (A) Polyps. (B) Gastric fundus varices. (C) Gastric ulcer. (D) Gastric cancer. (TIFF 6224 kb)

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Wang, YC., Pan, J., Jiang, X. et al. Repetitive Position Change Improves Gastric Cleanliness for Magnetically Controlled Capsule Gastroscopy. Dig Dis Sci 64, 1297–1304 (2019). https://doi.org/10.1007/s10620-018-5415-7

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  • DOI: https://doi.org/10.1007/s10620-018-5415-7

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