Roberta Elisa Rossi, Angelo Zullo, Silvia Ferretti, Giulia Migliorisi, Luigi Gatta, Vincenzo De Francesco, Alessandro Del Forno, Giacomo Marcozzi, Benedetta Masoni, Gianluca Franchellucci, Cesare Hassan, Alessandro Repici
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引用次数: 0
摘要
背景和目的：胃肠道（GI）出血或吸收不良是缺铁性贫血（IDA）最常见的病因。在接受上消化道和下消化道内窥镜检查的患者中，约有 10% 至 20% 的患者仍无法确定 IDA 的病因。在这种情况下，建议使用视频胶囊内镜（VCE）进行小肠检查。我们进行了一项系统性综述和荟萃分析，评估了VCE对无明显出血的IDA患者的诊断率，评估了任何病变或出血可能性高的病变的发生率：使用相关关键词进行计算机文献检索，找出截至2023年3月发表的所有相关文章：本系统综述纳入了12项研究，共计1703名IDA患者（男性：47%；年龄范围：19-92岁）。VCE对小肠总体病变的诊断率为61% (95% CI=44-77; 95 CI=97.2-98.1; I2=97.7%)。当仅分析可能导致 IDA 的小肠病变时，诊断率为 40% (95% CI=27-53; 95% CI=95.3-97; I2=96.3%)：VCE在无明显出血的IDA患者的诊断工作中发挥着重要作用，诊断率令人满意。
Diagnostic Yield of Small Bowel Videocapsule Endoscopy in Patients with Iron Deficiency Anemia. A Systematic Review and meta-analysis.
Background and aim: Gastrointestinal (GI) bleeding or malabsorption represents the most frequent aetiologies of iron deficiency anemia (IDA). The cause of IDA remains undetermined in ~10% to 20% of patients undergoing upper and lower GI endoscopies. In this scenario, a small bowel examination with videocapsule endoscopy (VCE) is recommended. We performed a systematic review with meta-analysis to evaluate the diagnostic yield of VCE in patients with IDA without overt bleeding, assessing the prevalence of either any lesion or lesions at high potential of bleeding.
Materials and methods: A computerized literature search was performed using relevant keywords to identify all the pertinent articles published until March 2023.
Results: Twelve studies with a total of 1703 IDA patients (Males: 47%; age range: 19-92 y) were included in this systematic review. The diagnostic yield of VCE for overall lesions in the small bowel was 61% (95% CI=44-77; 95 CI=97.2-98.1; I2 =97.7%). When analyzing only small bowel lesions likely responsible of IDA, the diagnostic yield was 40% (95% CI=27-53; 95% CI=95.3-97; I2 =96.3%).
Conclusion: VCE plays a relevant role in the diagnostic work-up of patients with IDA without overt bleeding with a satisfactory diagnostic yield.
期刊介绍：
Journal of Clinical Gastroenterology gathers the world''s latest, most relevant clinical studies and reviews, case reports, and technical expertise in a single source. Regular features include cutting-edge, peer-reviewed articles and clinical reviews that put the latest research and development into the context of your practice. Also included are biographies, focused organ reviews, practice management, and therapeutic recommendations.
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