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Video capsule colonoscopy in routine clinical practice

Toth, Ervin LU ; Yung, Diana E; Nemeth, Artur LU ; Johansson, Gabriele Wurm LU ; Thorlacius, Henrik LU and Koulaouzidis, Anastasios LU (2017) In Annals of Translational Medicine 5(9).
Abstract

Background: Colon capsule endoscopy (CCE) offers direct mucosal visualisation without sedation or gas insufflation required in conventional colonoscopy (CC). However, evidence for the role of CCE as an adjunct or alternative to CC remains equivocal. In this observational cohort study, we report our experience of using CCE to investigate patients with suspected colon pathology at a tertiary referral centre. Methods: From 2007-2015, consecutive patients requiring colonoscopy were recruited from a tertiary care centre in Malmo, Sweden. Data collected: patient demographics, indication for CCE, findings, bowel cleansing, colon transit time (CTT) and completeness of colon examination. Results: Seventy-seven patients (57 F/20 F, median age 56... (More)

Background: Colon capsule endoscopy (CCE) offers direct mucosal visualisation without sedation or gas insufflation required in conventional colonoscopy (CC). However, evidence for the role of CCE as an adjunct or alternative to CC remains equivocal. In this observational cohort study, we report our experience of using CCE to investigate patients with suspected colon pathology at a tertiary referral centre. Methods: From 2007-2015, consecutive patients requiring colonoscopy were recruited from a tertiary care centre in Malmo, Sweden. Data collected: patient demographics, indication for CCE, findings, bowel cleansing, colon transit time (CTT) and completeness of colon examination. Results: Seventy-seven patients (57 F/20 F, median age 56 years) were included. The reason for CCE was previously incomplete or refused CC in 39 and 26 cases, and follow up of previous findings in 12 cases, respectively. The main clinical indications were gastrointestinal (GI) bleeding (n=28; 36%) and suspected inflammatory bowel disease (IBD) or follow-up of known IBD (n=23; 30%). CCE was complete in 58/77 (75%) patients. In 3 patients the colon was not reached; in the other 16, the capsule reached the rectum (n=4), sigmoid (n=6), descending colon (n=5) and transverse colon (n=1). Findings were: normal CCE (n=15; 19%) colonic diverticula (n=29; 38%), polyps (n=17; 22%), active IBD (n=12; 16%), haemorrhoids (n=8; 10%), colonic angioectasia (n=4; 5%) and cancer (n=1; 1%). Small-bowel findings were recorded in 8 (10%) patients. All patients tolerated bowel preparation and CCE well. Two patients with an ulcerated small-bowel stricture and cancer respectively experienced temporary capsule retention with spontaneous resolution. Conclusions: CCE is a well-tolerated alternative to CC, but requires technological improvement and optimisation of clinical practice to meet current reference standards. Although further technical development is required, CCE may complement or even replace CC for certain clinical indications.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Capsule colonoscopy, Colon capsule endoscopy (CCE), Colorectal cancer (CRC), Gastrointestinal (GI) bleeding, Inflammatory bowel disease (IBD)
in
Annals of Translational Medicine
volume
5
issue
9
publisher
AME Publishing Company
external identifiers
  • scopus:85019265901
  • wos:000408638700003
ISSN
2305-5839
DOI
10.21037/atm.2017.03.91
language
English
LU publication?
yes
id
a70c9282-1ce4-48ec-a19e-df747a193719
date added to LUP
2017-06-08 16:40:13
date last changed
2018-01-07 12:06:43
@article{a70c9282-1ce4-48ec-a19e-df747a193719,
  abstract     = {<p>Background: Colon capsule endoscopy (CCE) offers direct mucosal visualisation without sedation or gas insufflation required in conventional colonoscopy (CC). However, evidence for the role of CCE as an adjunct or alternative to CC remains equivocal. In this observational cohort study, we report our experience of using CCE to investigate patients with suspected colon pathology at a tertiary referral centre. Methods: From 2007-2015, consecutive patients requiring colonoscopy were recruited from a tertiary care centre in Malmo, Sweden. Data collected: patient demographics, indication for CCE, findings, bowel cleansing, colon transit time (CTT) and completeness of colon examination. Results: Seventy-seven patients (57 F/20 F, median age 56 years) were included. The reason for CCE was previously incomplete or refused CC in 39 and 26 cases, and follow up of previous findings in 12 cases, respectively. The main clinical indications were gastrointestinal (GI) bleeding (n=28; 36%) and suspected inflammatory bowel disease (IBD) or follow-up of known IBD (n=23; 30%). CCE was complete in 58/77 (75%) patients. In 3 patients the colon was not reached; in the other 16, the capsule reached the rectum (n=4), sigmoid (n=6), descending colon (n=5) and transverse colon (n=1). Findings were: normal CCE (n=15; 19%) colonic diverticula (n=29; 38%), polyps (n=17; 22%), active IBD (n=12; 16%), haemorrhoids (n=8; 10%), colonic angioectasia (n=4; 5%) and cancer (n=1; 1%). Small-bowel findings were recorded in 8 (10%) patients. All patients tolerated bowel preparation and CCE well. Two patients with an ulcerated small-bowel stricture and cancer respectively experienced temporary capsule retention with spontaneous resolution. Conclusions: CCE is a well-tolerated alternative to CC, but requires technological improvement and optimisation of clinical practice to meet current reference standards. Although further technical development is required, CCE may complement or even replace CC for certain clinical indications.</p>},
  articleno    = {195},
  author       = {Toth, Ervin and Yung, Diana E and Nemeth, Artur and Johansson, Gabriele Wurm and Thorlacius, Henrik and Koulaouzidis, Anastasios},
  issn         = {2305-5839},
  keyword      = {Capsule colonoscopy,Colon capsule endoscopy (CCE),Colorectal cancer (CRC),Gastrointestinal (GI) bleeding,Inflammatory bowel disease (IBD)},
  language     = {eng},
  month        = {05},
  number       = {9},
  publisher    = {AME Publishing Company},
  series       = {Annals of Translational Medicine},
  title        = {Video capsule colonoscopy in routine clinical practice},
  url          = {http://dx.doi.org/10.21037/atm.2017.03.91},
  volume       = {5},
  year         = {2017},
}