パテンシーカプセル内視鏡の有用性

The Clinical Efficacy of Patency Capsule

要旨　2012年に本邦で市販されたPillCam^®パテンシーカプセル（PPC）は，小腸疾患に対するカプセル内視鏡検査（CE）の適応拡大に道を拓いた．PPCによるCEの前検査にあたっては，CE自体が禁忌と思われるようなイレウス症状を有する患者への施行に注意を要する．またPPCの消化管開通性の判定に関しては，腹部X線の撮影範囲に注意を要するとともに，本邦での大腸到達が確信できない所見の場合にはCEを施行しないことが肝要である．Crohn病やNSAIDs腸炎などの患者数増加や長期予後改善の指標となる内視鏡的粘膜治癒に対する認識の高まりを背景に，今後PPCを介したCEの機会が増加すると思われ，その適正使用が望まれる．

　PPC（PillCam^® patency capsule）which was marketed in 2012 in Japan has expanded the indication of small bowel disease for CE（capsule endoscopy）. We have to be careful in cases of patients with intestinal obstruction symptoms and contraindication for CE, during PPC examination prior to CE. And we also have to take care that the range of abdominal X-ray should included the bottom of the pelvis for judging functional patency of the gastrointestinal tract. If it is difficult for the physician to judge with certainly that the PPC will go through the colon, CE has to be cancelled. The frequency of PPC examination is expected to increase in Japan, because the number of patients with Crohn's disease or NSAIDs（non-steroid anti-inflammatory drugs）enteropathy will increase, and there is rising concern about endoscopic mucosal healing as the optimal treatment goal for better prognosis. Therefore, proper usage of PPC is an important issue to optimize endoscopic examination of the small bowel.