scholarly journals Booster medication to achieve capsule excretion in colon capsule endoscopy: a randomized controlled trial of three regimens

2018 ◽  
Vol 06 (11) ◽  
pp. E1363-E1368 ◽  
Author(s):  
Rasmus Kroijer ◽  
Anne-Kirstine Dyrvig ◽  
Morten Kobaek-Larsen ◽  
Jens Overgaard Støvring ◽  
Niels Qvist ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Capsule Endoscopy ◽  
Completion Rate ◽  
Oral Contrast ◽  
Recording Time ◽  
Colon Capsule Endoscopy ◽  
Bowel Cleansing ◽  
Colon Capsule ◽  
Group A ◽  
Group B

Abstract Background and study aims To achieve a complete colon capsule endoscopy, the entire colon must be visualized, clean and filled with clear fluids. The primary aim was to compare three booster regimens in colon capsule endoscopy in achieving capsule excretion within recording time. Secondary aims were quality of bowel cleansing and completion rate (both adequate cleansing and capsule excretion). Patients and methods Patients scheduled for follow-up colonoscopy due to previous neoplastic findings or familial history of colorectal cancer aged 18 to 70 years were eligible. Bowel preparation was 2-L split doses of polyethylene glycol. Patients were randomized to three booster regimens of either polyethylene glycol (Group A), sulfate-based solution (Group B) or polyethylene glycol with iodine oral contrast (Group C). Results One hundred eighty participants were included and randomized into three groups of 60. Capsule excretion was 70 % (95 % CI: 58 – 80) in Group A, 73 % (95 % CI: 61 – 83) in Group B and in 68 % (95 % CI: 56 – 79) in Group C, no statistically significant differences. Bowel cleansing grade was statistically significant better in Group B compared to Group A (P = 0.03), but there were no statistically significant differences between Groups C and A (P = 0.40). Complete examination rate was 65 % (95 % CI: 53 – 77), 72 % (95 % CI: 61 – 83) and 62 % (95 % CI: 50 – 74) in Group A, B and C respectively, not statistically significant different. Conclusions Sulfate-based solution resulted in statistically significant better bowel cleansing compared to polyethylene glycol. Overall the excretion and completion rate was suboptimal. Achieving a high completion rate using patient-tolerable and low-risk compounds is still a challenge.

scholarly journals Colon Capsule Endoscopy vs. CT Colonography Following Incomplete Colonoscopy: A Systematic Review with Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3367
Author(s):  
Ulrik Deding ◽  
Lasse Kaalby ◽  
Henrik Bøggild ◽  
Eva Plantener ◽  
Mie Kruse Wollesen ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Rate Sensitivity ◽  
Completion Rate ◽  
Polyp Detection ◽  
Proximal Point ◽  
Incomplete Colonoscopy ◽  
Colon Capsule Endoscopy ◽  
Colon Capsule

Following incomplete colonoscopy (IC) patients often undergo computed tomography colonography (CTC), but colon capsule endoscopy (CCE) may be an alternative. We compared the completion rate, sensitivity and diagnostic yield for polyp detection from CCE and CTC following IC. A systematic literature search resulted in twenty-six studies. Extracted data included inter alia, complete/incomplete investigations and polyp findings. Pooled estimates of completion rates of CCE and CTC and complete colonic view rates (CCE reaching the most proximal point of IC) of CCE were calculated. Per patient diagnostic yields of CCE and CTC were calculated stratified by polyp sizes. CCE completion rate and complete colonic view rate were 76% (CI 95% 68–84%) and 90% (CI 95% 83–95%). CTC completion rate was 98% (CI 95% 96–100%). Diagnostic yields of CTC and CCE were 10% (CI 95% 7–15%) and 37% (CI 95% 30–43%) for any size, 13% (CI 95% 9–18%) and 21% (CI 95% 12–32%) for >5-mm and 4% (CI 95% 2–7%) and 9% (CI 95% 3–17%) for >9-mm polyps. No study performed a reference standard follow-up after CCE/CTC in individuals without findings, rendering sensitivity calculations unfeasible. The increased diagnostic yield of CCE could outweigh its slightly lower complete colonic view rate compared to the superior CTC completion rate. Hence, CCE following IC appears feasible for an introduction to clinical practice. Therefore, randomized studies investigating CCE and/or CTC following incomplete colonoscopy with a golden standard reference for the entire population enabling estimates for sensitivity and specificity are needed.

scholarly journals Colon capsule endoscopy in clinical practice: lessons from a national 5-year observational prospective cohort

2021 ◽  
Vol 09 (10) ◽  
pp. E1542-E1548
Author(s):  
Nicolas Benech ◽  
Olivier Vinet ◽  
Jean-Louis Gaudin ◽  
Robert Benamouzig ◽  
Xavier Dray ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Real Life ◽  
Average Risk ◽  
Advanced Neoplasia ◽  
Medical Centers ◽  
Colon Capsule Endoscopy ◽  
Bowel Cleansing ◽  
National Cohort ◽  
Colon Capsule ◽  
Technical Issues

Abstract Background and study aims Colon capsule endoscopy (CCE) has been proposed as an alternative to colonoscopy for screening patients at average risk of colorectal cancer (CRC). A prospective national cohort was developed to assess relevance of CCE in real-life practice and its short- and long-term impacts on clinical management. Patients and methods All patients who underwent a CCE in France were prospectively enrolled from January 2011 to May 2016 and reached annually by phone until May 2017. All CCE and colonoscopy reports were systematically collected. Results During the study period, 689 CCEs were analyzed from 14 medical centers. Median follow-up time was 35 months [IQR: 12–50]. Indication for CCE was mainly for elderly patients (median age: 70 years, IQR: [61–79]) due to anesthetic or colonoscopy contraindication (n = 307; 44.6 %). Only 337 CCEs (48.9 %) were both complete and with adequate bowel preparation. Advanced neoplasia (adenoma with high-grade dysplasia or CRC) was diagnosed following 32 CCEs (4.6 %). Among patients who underwent colonoscopy or therapeutic surgery following CCE, 18.8 % of all advanced neoplasias (6/32) had not been diagnosed by CCE mainly due to technical issues. Performing a colonoscopy in the case of significant polyps or insufficient bowel cleansing or after an incomplete CCE allowed the diagnosis of 96.9 % of all identified advanced neoplasias (31/32). Conclusions Outside the scope of academic trials, improvement is needed to increase the reliability of CCE as less than half were considered optimal i. e. complete with adequate bowel cleansing. Most of missed colonic advanced neoplasia were due to incomplete CCE with distal neoplasia location.

scholarly journals Assessment of bowel cleansing quality in colon capsule endoscopy using machine learning: a pilot study

2018 ◽  
Vol 06 (08) ◽  
pp. E1044-E1050 ◽  
Author(s):  
Maria Magdalena Buijs ◽  
Mohammed Hossain Ramezani ◽  
Jürgen Herp ◽  
Rasmus Kroijer ◽  
Morten Kobaek-Larsen ◽  
...  
Keyword(s):  
Machine Learning ◽  
Pilot Study ◽  
Capsule Endoscopy ◽  
Analysis Model ◽  
Specific Analysis ◽  
Colon Capsule Endoscopy ◽  
Bowel Cleansing ◽  
Colon Capsule ◽  
Pixel Analysis ◽  
Almost All

Abstract Background and study aims The aim of this study was to develop a machine learning-based model to classify bowel cleansing quality and to test this model in comparison to a pixel analysis model and assessments by four colon capsule endoscopy (CCE) readers. Methods A pixel analysis and a machine learning-based model with four cleanliness classes (unacceptable, poor, fair and good) were developed to classify CCE videos. Cleansing assessments by four CCE readers in 41 videos from a previous study were compared to the results both models yielded in this pilot study. Results The machine learning-based model classified 47 % of the videos in agreement with the averaged classification by CCE readers, as compared to 32 % by the pixel analysis model. A difference of more than one class was detected in 12 % of the videos by the machine learning-based model and in 32 % by the pixel analysis model, as the latter tended to overestimate cleansing quality. A specific analysis of unacceptable videos found that the pixel analysis model classified almost all of them as fair or good, whereas the machine learning-based model identified five out of 11 videos in agreement with at least one CCE reader as unacceptable. Conclusions The machine learning-based model was superior to the pixel analysis in classifying bowel cleansing quality, due to a higher sensitivity to unacceptable and poor cleansing quality. The machine learning-based model can be further improved by coming to a consensus on how to classify cleanliness of a complete CCE video, by means of an expert panel.

scholarly journals Applicability of colon capsule endoscopy as pan-endoscopy: From bowel preparation, transit, and rating times to completion rate and patient acceptance

2021 ◽  
Vol 09 (12) ◽  
pp. E1852-E1859 ◽  
Author(s):  
Fanny E.R. Vuik ◽  
Sarah Moen ◽  
Stella A.V. Nieuwenburg ◽  
Eline H. Schreuders ◽  
Ernst J. Kuipers ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Capsule Endoscopy ◽  
Bowel Preparation ◽  
Reading Time ◽  
Completion Rate ◽  
Patient Acceptance ◽  
Safe Procedure ◽  
Serious Adverse Events ◽  
Colon Capsule Endoscopy ◽  
Colon Capsule

Abstract Background and study aims Colon capsule endoscopy (CCE) has the potential to explore the entire gastrointestinal tract. The aim of this study was to assess the applicability of CCE as pan-endoscopy. Patients and methods Healthy participants received CCE with bowel preparation (bisacodyl, polyethylene electrolyte glycol (PEG) + ascorbic acid) and booster regimen (metoclopramide, oral sulfate solution (OSS)). For each segment of the gastrointestinal tract, the following quality parameters were assessed: cleanliness, transit times, reading times, patient acceptance and safety of the procedure. When all gastrointestinal segments had cleansing score good or excellent, cleanliness of the whole gastrointestinal tract was assessed as good. Participants’ expected and perceived burden was assessed by questionnaires and participants were asked to grade the procedure (scale 0–10). All serious adverse events (SAEs) were documented. Results A total of 451 CCE procedures were analyzed. A good cleansing score was achieved in the stomach in 69.6%, in the SB in 99.1 % and in the colon in 76.6 %. Cleanliness of the whole gastrointestinal tract was good in 52.8 % of the participants. CCE median transit time of the whole gastrointestinal tract was 583 minutes IQR 303–659). The capsule reached the descending colon in 94.7 %. Median reading time per procedure was 70 minutes (IQR 57–83). Participants graded the procedure with a 7.8. There were no procedure-related SAEs. Conclusions CCE as pan-endoscopy has shown to be a safe procedure with good patient acceptance. When cleanliness of all gastrointestinal segments per patient, completion rate and reading time will be improved, CCE can be applied as a good non-invasive alternative to evaluate the gastrointestinal tract.

Sa1112 Comparison of Polyethylene Glycol and Sulfate Solution as Cleansing Regimen for Colon Capsule Endoscopy

2017 ◽  
Vol 85 (5) ◽  
pp. AB195-AB196
Author(s):  
Fanny E. Vuik ◽  
Eline H. Schreuders ◽  
Els Wieten ◽  
Sophia van Baalen ◽  
Ernst J. Kuipers ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Capsule Endoscopy ◽  
Sulfate Solution ◽  
Colon Capsule Endoscopy ◽  
Colon Capsule

scholarly journals Diagnostic Role of Colon Capsule Endoscopy in Patients with Optimal Colon Cleaning

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Ümit Akyüz ◽  
Yusuf Yılmaz ◽  
Ali Tüzün İnce ◽  
Bülent Kaya ◽  
Cengiz Pata
Keyword(s):  
Capsule Endoscopy ◽  
Diagnostic Value ◽  
Liquid Diet ◽  
The Other ◽  
Diagnostic Modality ◽  
Colon Capsule Endoscopy ◽  
Internal Hemorrhoids ◽  
Colon Capsule ◽  
Group B ◽  
Sensitivity Specificity

Background. Colon capsule endoscopy (CCE) is a diagnostic test with relatively rare usage. In this study, we aimed to evaluate both the optimal cleaning regimen for CCE and the diagnostic value of test in the study group.Methods. A total of 62 patients were enrolled in this study. In the first step, 3 different colon preparing regimens were given to 30 patients [Group A: 3 days of liquid diet, sodium phosphate (NaP) (90 mL), and NaP enema;Group B: 3 days of liquid diet, 4 L of polyethylene glycol (PEG), and metoclopramide;Group C: 3 days of liquid diet, 4 L of PEG, NaP (45 mL), and bisacodyl after capsule ingestion] (10 patients in each group). The other consecutive 32 patients were cleaned with the best regimen which was NaP + PEG and CCE was performed. The results of CCE were controlled with colonoscopy in 28 patients.Results. Group C had the highest cleaning score, compared with the other groups (2.2±0.4versus2.7±0.4versus3.7±0.4,pvalue=0.000). The CCE findings were as follows in 28 patients who were also examined with colonoscopy: polyp (range: 5–10 mm) in 6 patients, internal hemorrhoids in 3 patients, angiodysplasia in 1 patient, diverticula in 1 patient, and ulcerative colitis in 1 patient. The sensitivity, specificity, PPV, and NPV of CCE were 100%, 92%, 93%, and 100%, respectively.Conclusions. Low dosage NaP combined with PEG provides optimal bowel preparation for CCE. CCE appears to be a highly sensitive diagnostic modality for detecting colonic pathologies.

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