Colon Capsule Endoscopy: An Alternative for Conventional Colonoscopy?

BACKGROUND: Conventional colonoscopy (CC) is the gold standard for diagnostic examination of the colon. However, the overall acceptance of this procedure is low due to patient fears of complications or embarrassment. Colon capsule endoscopy (CCE) represents a minimally invasive, patient-friendly procedure that offers complete visualization of the entire intestine.OBJECTIVE: To assess the PillCam Colon 2 (Given Imaging Ltd, Israel) capsule with regard to feasibility, sensitivity and specificity for the detection of colonic pathologies and additional recorded extracolonic findings.METHODS: CCE was performed before CC in patients indicated for CC for known or suspected colonic disease. The results of both techniques were compared with regard to polyp detection. Additionally, bowel preparation and extracolonic pathologies were analyzed.RESULTS: Twenty-four patients (mean age 51.1 years) were included in the analysis. Visualization of the colon was complete in 23 CCs and 17 CCEs. No adverse events or major technical failures occurred. CC detected 47 polyps and CCE detected 43 polyps of any size (per-finding sensitivity 90.9%, specificity 67.6%). The accuracy of CCE in detecting polyp carriers was 81.5% (per-patient analysis). On average, the colon was adequately cleansed in 90.1% of patients. CCE identified esophageal, gastric and small bowel pathologies in seven (24%), nine (38%) and 14 (58%) patients, respectively.CONCLUSIONS: CCE proved to be technically feasible and safe. Acceptable sensitivity and moderate specificity levels in polyp detection were recorded. Bowel preparation was adequate in most patients. Because extracolonic pathologies were effectively visualized, new indications for the PillCam Colon 2 may be defined.

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Patient-Reported Outcomes and Preferences for Colon Capsule Endoscopy and Colonoscopy: A Systematic Review with Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11091730 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1730

Author(s):

Ulrik Deding ◽

Pablo Cortegoso Valdivia ◽

Anastasios Koulaouzidis ◽

Gunnar Baatrup ◽

Ervin Toth ◽

...

Keyword(s):

Adverse Events ◽

Capsule Endoscopy ◽

Patient Preferences ◽

Patient Reported Outcomes ◽

Meta Analysis ◽

Conventional Colonoscopy ◽

Colon Capsule Endoscopy ◽

Significant Difference ◽

Patient Reported ◽

Colon Capsule

Colon capsule endoscopy as an alternative to colonoscopy for the diagnosis of colonic disease may serve as a less invasive and more tolerable investigation for patients. Our aim was to examine patient-reported outcomes for colon capsule endoscopy compared to conventional optical colonoscopy including preference of investigation modality, tolerability and adverse events. A systematic literature search was conducted in Web of Science, PubMed and Embase. Search results were thoroughly screened for in- and exclusion criteria. Included studies underwent assessment of transparency and completeness, after which, data for meta-analysis were extracted. Pooled estimates of patient preference were calculated and heterogeneity was examined including univariate meta-regressions. Patient-reported tolerability and adverse events were reviewed. Out of fourteen included studies, twelve had investigated patient-reported outcomes in patients who had undergone both investigations, whereas in two the patients were randomized between investigations. Pooled patient preferences were estimated to be 52% (CI 95%: 41–63%) for colon capsule endoscopy and 45% (CI 95%: 33–57%) for conventional colonoscopy: not indicating a significant difference. Procedural adverse events were rarely reported by patients for either investigation. The tolerability was high for both colon capsule endoscopy and conventional colonoscopy. Patient preferences for conventional colonoscopy and colon capsule endoscopy were not significantly different. Procedural adverse events were rare and the tolerability for colon capsule endoscopy was consistently reported higher or equal to that of conventional colonoscopy.

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Comparison of small-bowel colon capsule endoscopy system to conventional colonoscopy for the evaluation of ulcerative colitis activity

Endoscopy International Open ◽

10.1055/a-0982-2786 ◽

2019 ◽

Vol 07 (10) ◽

pp. E1253-E1261 ◽

Cited By ~ 1

Author(s):

Samuel N. Adler ◽

Yago González Lama ◽

Virginia Matallana Royo ◽

Cristina Suárez Ferrer ◽

Avraham Schwartz ◽

...

Keyword(s):

Ulcerative Colitis ◽

Small Bowel ◽

Adverse Events ◽

Disease Activity ◽

Capsule Endoscopy ◽

Kappa Coefficient ◽

Conventional Colonoscopy ◽

Percent Agreement ◽

Colon Capsule Endoscopy ◽

Colon Capsule

Abstract Background and aims Diagnosis and monitoring of ulcerative colitis (UC) includes conventional colonoscopy. This procedure is invasive and does not exclude small-bowel Crohn’s disease (CD). Current therapeutic goals include mucosal healing which may lead to an increased number of endoscopic procedures in many patients. The small-bowel colon capsule endoscopy (SBC-CE) system visualizes the small bowel and colon. The aim of this study was to evaluate the performance and adverse events of SBC-CE in patients with UC. Methods This was a prospective, feasibility study involving two study sites. Patients with active UC underwent SBC-CE and colonoscopy. Kappa statistics were performed to assess the agreement between SBC-CE and colonoscopy. Adverse events (AEs) data were collected throughout and following the procedure. Results In total, 30 consecutive patients were recruited, and 23 of those were included in the final analysis. For the primary end point, evaluation of the extent of UC disease in the colon, the percent agreement between SBC-CE and colonoscopy was moderate (56.5 %); kappa coefficient 0.42. The percent agreement between SBC-CE and colonoscopy for UC disease activity, based on Mayo endoscopic sub-score, was 95.7 %; kappa coefficient 0.86. Disease activity in the more proximal small bowel was detected in two patients with SBC-CE. No SBC-CE device-related AEs were reported. Conclusions When comparing SBC-CE to conventional colonoscopy, there was a moderate agreement for the extent of UC disease and a very good overall agreement between the two modalities for UC disease activity.

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Mo1979 Small Bowel-Colon Capsule Endoscopy System for the Evaluation of Ulcerative Colitis Activity and Its Agreement With Conventional Colonoscopy, a Feasibility Study

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2017.03.1166 ◽

2017 ◽

Vol 85 (5) ◽

pp. AB504

Author(s):

Samuel N. Adler ◽

Virginia Matallana Royo ◽

Ariella B. Shitrit ◽

Cristina Suarez Ferrer ◽

Avraham Schwartz ◽

...

Keyword(s):

Ulcerative Colitis ◽

Small Bowel ◽

Feasibility Study ◽

Capsule Endoscopy ◽

Conventional Colonoscopy ◽

Colon Capsule Endoscopy ◽

Colon Capsule

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Scoring Systems for Clinical Colon Capsule Endoscopy—All You Need to Know

Journal of Clinical Medicine ◽

10.3390/jcm10112372 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2372

Author(s):

Trevor Tabone ◽

Anastasios Koulaouzidis ◽

Pierre Ellul

Keyword(s):

Capsule Endoscopy ◽

Diagnostic Yield ◽

Colonic Polyps ◽

Scoring Systems ◽

Conventional Colonoscopy ◽

Suitable Alternative ◽

Specific Patient ◽

Colon Capsule Endoscopy ◽

Colon Capsule ◽

Event Rates

In the constantly developing era of minimal diagnostic invasiveness, the role of colon capsule endoscopy in colonic examination is being increasingly recognised, especially in the context of curtailed endoscopy services due to the COVID-19 pandemic. It is a safe diagnostic tool with low adverse event rates. As with other endoscopic modalities, various colon capsule endoscopy scores allow the standardisation of reporting and reproducibility. As bowel cleanliness affects CCE’s diagnostic yield, a few operator-dependent scores (Leighton–Rex and CC-CLEAR scores) and a computer-dependent score (CAC score) have been developed to grade bowel cleanliness objectively. CCE can be used to monitor IBD mucosal disease activity through the UCEIS and the panenteric CECDAIic score for UC and CD, respectively. CCE may also have a role in CRC screening, given similar sensitivity and specificity rates to conventional colonoscopy to detect colonic polyps ≥ 10 mm and CRC. Given CCE’s diagnostic yield and reproducible clinical scores with high inter-observer agreements, CCE is fast becoming a suitable alternative to conventional colonoscopy in specific patient populations.

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