String Esophageal Capsule Endoscopy With Real-Time Viewing Improves Visualization Of The Distal Esophageal Z-Line: A Prospective, Comparative Study

ObjectiveEsophageal capsule endoscopy (ECE) is relatively limited because of poor visualization of the distal esophagus. This study aimed to investigate whether string esophageal capsule endoscopy with real-time viewing (SECE+RTV) could improve the Z-line viewing of the distal esophagus as compared with conventional ECE.MethodsThirty healthy volunteers, aged 20-45 years, were recruited and underwent SECE+RTV and ECE sequentially. The main outcome measures included grade of air-bubble and saliva interference, success rate of Z-line viewing (frequency of visualizing at least three quadrants), and frame number of images captured on the Z-line.ResultsSECE+RTV showed a significantly greater percentage of no or mild air-bubble/saliva interference at the gastroesophageal junction [SECE+RTV vs. ECE, 90.0% (27/30) vs. 10.0% (3/30), P<0.001]. SECE+RTV had a significantly greater frame number of images captured on the Z-line (154.46.3 vs. 46 +/- 5.1, P<0.001). Moreover, SECE+RTV had significantly greater percentages of at least two quadrants [100.0% (30/30) vs. 80.0% (24/30), P<0.001] and at least three quadrants [90.0% (27/30) vs. 36.7% (11/30), P<0.001] of Z-line visualization.ConclusionCompared with ECE, SECE+RTV provides a better view of the distal esophagus in healthy individuals.