PillCamColon2 after incomplete colonoscopy - a prospective multicenter study

  • Aim: To evaluate the ability of PillCamColon2 to visualize colonic segments missed by incomplete optical colonoscopy (OC) and to assess the diagnostic yield. Methods: This prospective multicentre study included 81 patients from nine centres who underwent second-generation colon capsule endoscopy (CCE) following incomplete OC performed by an experienced gastroenterologist (> 1000 colonoscopies). Patients with stenosis were excluded. According to patient preferences, CCE was performed the following day (protocol A) after staying on clear liquids and 0.75 L Moviprep in the morning or within 30 d after new split-dose Moviprep (protocol B). Boosts consisted of 0.75 L and 0.25 L Moviprep, and phospho-soda was given as a rescue if the capsule was not excreted after seven hours. Results: Seventy-four patients were analysed (51% of them in group A; 49% in group B). Bowel cleansing was adequate in 67% of cases, and CCE could visualize colonic segments missed by incomplete colonoscopy in 90% of patients under protocol A and 97% of patients under protocol B (P = 0.35, n.s.). Significant polyps including adenocarcinoma were detected in 24% of cases. Detection rates for all polyps and significant polyps per patient were similar in both protocols. Polyps were found predominantly in the right colon (86%) in segments that were not reached by OC. Extracolonic findings - such as reflux esophagitis, suspected Barrett esophagus, upper GI-bleeding, gastric polyps, gastric erosions and angiectasia - were detected in eight patients. PillCamColon2 capsule was retained in the ileum of one patient (1.4%) without symptoms and removed during an uneventful resection for unknown Crohn’s disease that was diagnosed as the cause of anemia, which was the indication for colonoscopy. CCE was well tolerated. One patient suffered from self-limiting vomiting after consuming the phospho-soda. Conclusion: Second-generation CCE using a low-volume preparation is useful after incomplete OC, and it allows for the detection of additional relevant findings, but cleansing efficiency could be improved.

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Author:Peter Baltes, Marc Bota, Jörg Gerhard AlbertORCiDGND, Michael PhilipperORCiD, Hans-Georg Hörster, Friedrich Hagenmüller, Ingo Steinbrück, Ralf Jakobs, Matthias Bechtler, Dirk Hartmann, Horst Neuhaus, Jean-Pierre Charton, Rupert Mayershofer, Horst HohnORCiDGND, Thomas Rösch, Stefan Groth, Tanja Nowak, Peter Wohlmuth, Martin Keuchel
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/30131662
Parent Title (English):World journal of gastroenterology
Publisher:WJG Press
Place of publication:Beijing
Document Type:Article
Year of Completion:2018
Date of first Publication:2018/08/21
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2018/12/11
Tag:Cleanliness level; Colon capsule endoscopy; Complementation rate; Incomplete colonoscopy; Low volume prep; Moviprep; Phospho-soda; PillCamColon2; Polyps
Page Number:15
First Page:3556
Last Page:3566
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0