Colon capsule endoscopy: Advantages, limitations and expectations. Which novelties?

Abstract

Since the first reports almost ten years ago, wireless capsule endoscopy has gained new fields of application. Colon capsule endoscopy represents a new diagnostic technology for colonic exploration. Clinical trials have shown that colon capsule endoscopy is feasible, accurate and safe in patients suffering from colonic diseases and might be a valid alternative to conventional colonoscopy in selected cases such as patients refusing conventional colonoscopy or with contraindications to colonoscopy or when colonoscopy is incomplete. Despite the enthusiasm surrounding this new technique, few clinical and randomized controlled trials are to be found in the current literature, leading to heterogeneous or controversial results. Upcoming studies are needed to prove the substantial utility of colon capsule endoscopy for colon cancer screening, especially in a low prevalence of disease population, and for other indications such as inflammatory bowel disease. Possible perspectives are critically analysed and reported in this paper.

Assessment of mucosal healing in inflammatory bowel disease: review

“…The diagnostic accuracy of VCE for colon inflammation has been investigated in patients with UC, and the sensitivity (77%), specificity (78%), positive predictive value (81%), and negative predictive value (74%) were demonstrated to be only modest when compared with conventional endoscopy. 77 In CD, although a strong-to-moderate correlation between VCE and conventional endoscopy was found, VCE systematically underestimated severity of disease. Furthermore, the sensitivity and specificity for detecting colon ulceration was only 86% and 40%, respectively.…”

Capsule endoscopy: Coming of age!

“…It also has automated small bowel identification feature. [2,3] These advances raise the hope of a pan-endoscopy becoming feasible with CE, and further technological enhancements must address this goal. Pan-endoscopy may find utility in evaluation of cause of abdominal pain, iron deficiency anemia, and gastrointestinal bleeding, disease extent in CD, search for a gastrointestinal primary in metastatic disease and evaluation of polyposis syndromes.…”

Emerging issues and future developments in capsule endoscopy

“…The PillCam® COLON2 is actively used in Europe and Japan and has gained FDA clearance in 2014 in the United States for use in patients following an incomplete colonoscopy (www.givenimaging.com). Capsule colonoscopy is not yet considered a replacement to traditional colonoscopy due to specificity rates recorded as low as 64% (20). Impact due to lack of active steering techniques and inability to distend collapsed tissue may lead to reduced visibility (20).…”

“…Capsule colonoscopy is not yet considered a replacement to traditional colonoscopy due to specificity rates recorded as low as 64% (20). Impact due to lack of active steering techniques and inability to distend collapsed tissue may lead to reduced visibility (20). …”