Intraoperative bowel cleansing tool in active locomotion capsule endoscopy

Background/Aims. Capsule endoscopy (CE) is a noninvasive test for diagnosing small bowel disorders. However, several studies reported that the CE-based visualization is suboptimal. This study, the first to use two CEs simultaneously, aimed at evaluating the diagnostic ability of dual CE. Methods. Dual CE procedures were prospectively conducted. All patients completed bowel cleansing 2 hours before examination. Subsequently, they simultaneously swallowed two capsules: MiroCam (IntroMedic, Seoul, Korea) and PillCam SB3 (Medtronic, Minneapolis, USA). We assessed the completeness and feasibility of small bowel examination and the detection rate of duodenal papilla and diagnostic yield. Results. Twenty consecutive patients who underwent complete small bowel examination with dual CE were enrolled in the study. The mean time of small bowel passage was 245 ± 99 min. Dual CE examination increased the duodenal papilla detection rate to up to 75% (versus PillCam SB3 alone (P=0.031) and MiroCam alone (P=0.063)) and overall diagnostic yield to up to 70% (P=0.063) in comparison to single CE. Adverse events or electrical interference during data transmission between the two capsule endoscopes were not detected. Conclusions. In this study, we found that dual CE enhances diagnostic accuracy and could increase the diagnostic power of existing CE systems using simply applicable methods. This trial is registered with KCT0002541.

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Polyethylene glycol plus an oral sulfate solution as a bowel cleansing regimen for colon capsule endoscopy: a prospective, single-arm study in healthy volunteers

Therapeutic Advances in Gastroenterology ◽

10.1177/1756283x15586355 ◽

2015 ◽

Vol 8 (5) ◽

pp. 248-254 ◽

Cited By ~ 1

Author(s):

Pankaj K. Kashyap ◽

Ravit Peled

Keyword(s):

Polyethylene Glycol ◽

Healthy Volunteers ◽

Capsule Endoscopy ◽

Sulfate Solution ◽

Colon Capsule Endoscopy ◽

Bowel Cleansing ◽

Colon Capsule

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PWE-055 Bowel Cleansing Agents Enhance Reader Confidence Levels When Excluding Significant Findings At Capsule Endoscopy

Gut ◽

10.1136/gutjnl-2014-307263.315 ◽

2014 ◽

Vol 63 (Suppl 1) ◽

pp. A147.2-A147

Author(s):

R Rameshshanker ◽

A O’Rourke ◽

J Butcher ◽

C Fraser

Keyword(s):

Capsule Endoscopy ◽

Confidence Levels ◽

Bowel Cleansing

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

Endoscopy International Open ◽

10.1055/a-1526-0923 ◽

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.

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

Endoscopy International Open ◽

10.1055/a-0627-7136 ◽

2018 ◽

Vol 06 (08) ◽

pp. E1044-E1050 ◽

Cited By ~ 4

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.

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Bowel Preparation for Small Bowel Capsule Endoscopy: Is There Still a Role for Polyethylene Glycol?

Journal of Digestive Endoscopy ◽

10.1055/s-0040-1716581 ◽

2020 ◽

Vol 11 (03) ◽

pp. 215-222

Author(s):

Paul Collins ◽

Neil Haslam ◽

Anthony Morris ◽

Thomas Skouras ◽

Ashley Bond

Keyword(s):

Polyethylene Glycol ◽

Small Bowel ◽

Transit Time ◽

Capsule Endoscopy ◽

Bowel Preparation ◽

Diagnostic Yield ◽

Statistical Significance ◽

Deficiency Anemia ◽

Bowel Cleansing ◽

The Impact

Abstract Objectives This study aimed to assess the impact of polyethylene glycol (PEG) bowel cleansing on performance characteristics of small bowel capsule endoscopy (SBCE). Materials and Methods Data from consecutive patients undergoing SBCE in the period before and after the introduction of PEG 2 L bowel cleansing with PEG were collated retrospectively. The indication, diagnostic yield (DY), clinical outcome, small bowel transit time, gastric transit time, and completion rate were recorded for each procedure. Results Data from 286 patients were analyzed. PEG 2 L was not superior to 12-hour fasting for DY (66 [53%] vs. 76 [47%] patients [p = 0.348]), or DY for significant findings (findings requiring a further intervention or investigation; 29 [23%] vs. 52 [32%] patients [p = 0.090]).There was a trend toward an increased DY for significant findings in patients undergoing investigation for iron-deficiency anemia (IDA) receiving PEG 2 L that just failed to meet statistical significance (13 [31%] and 25 [21%] patients, respectively [p = 0.06]). Transit times and completion rates were unaffected by bowel cleansing. Conclusion Bowel cleansing with PEG 2 L is not superior to fasting for overall DY in SBCE. PEG 2 L may confer an advantage for the detection of significant lesions in patient with IDA. Further investigation of optimal modes of bowel preparation is indicated.

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