Pan-enteric capsule for bleeding high-risk patients. Can we limit endoscopies?

Ribón, Cristina Carretero; Prieto-Frías, César; Angós, Ramón; Betés, Maite; Bayod, Maite Herráiz; Riva, S.; Zozaya, Francisco Javier; Fernández-Calderón, María; Rodríguez‐Lago, Iago; Navas, Miguel Muñoz

doi:10.17235/reed.2020.7196/2020

Cited by 8 publications

(18 citation statements)

References 8 publications

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“…Furthermore, although no formal standard quality measure exists, the rate of patients with adequate cleansing of the whole gastrointestinal tract (52.8 %) is far from being acceptable. Finally, as far as the completion rate for colon evaluation is concerned, the 51 % rate reported by Vuik et al [2] is similar to those reported in other publications [7][8][9] and far below the recommended threshold of 90 % [6].…”

supporting

confidence: 85%

Colon capsule for panendoscopy: a narrow window of opportunity

Rondonotti

Pennazio

2021

Endosc Int Open

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supporting

confidence: 85%

Colon capsule for panendoscopy: a narrow window of opportunity

Rondonotti

Pennazio

2021

Endosc Int Open

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“…(3) CD, whose extension and monitoring may actually involve both small bowel and colon, probably is the indication with the highest benefit from a panintestinal exploration and, as a matter of fact, it is the most studied setting: only three [4,5,13] studies were performed on non-IBD patients. Notwithstanding, although the diagnostic yield of panintestinal CE is high when compared to gold standard techniques [15][16][17][18]23], sample sizes are too low to gather solid evidence.…”

Section: Discussionmentioning

confidence: 99%

“…After fulltext evaluation, 23 articles were excluded. This approach yielded 16 studies (all in English language) [3][4][5][6][13][14][15][16][17][18][19][20][21][22][23][24] that were eventually included in the systematic review (Fig. 1).…”

Section: Search Strategymentioning

confidence: 99%

“…Overall, 10 single-center [3][4][5][13][14][15][16]19,20,22] and 6 multicenter observational studies were selected [6,17,18,21,23,24], including 794 patients (Table 1). In all but three (n = 3) studies [4,5,13], panintestinal CE was performed specifically on patients with CD. In one (n = 1) study [19], CE was performed on pediatric patients.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…Cleanliness parameters were not described in 4/16 studies [13,16,20,24]; moreover, in the study by Leighton et al [18] the cleansing score was expressed only per colonic segment. The completeness rate (number/%) of the procedures is summarized in Table 3.…”

Section: Cleanliness and Completenessmentioning

confidence: 99%

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Clinical feasibility of panintestinal (or panenteric) capsule endoscopy: a systematic review

Valdivia

Elosua²,

Houdeville

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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In recent years, panintestinal capsule endoscopy (PCE) with double-headed capsules has been used to perform complete, single-sitting exploration of both small bowel and colon in different clinical conditions. Double-headed capsules for colonic examination (CCE) have been exploited first in this setting, followed by newer generations of capsules (i.e. PillCam Crohn, PCC) specifically engineered for this purpose. The aim of this study was to evaluate the feasibility of PCE in the form of a systematic review. We performed a comprehensive literature search to identify papers in which CE was specifically used for a PCE of the gastrointestinal tract. Data on CE, bowel preparation regimen, rate of cleanliness and completeness, and data on transit times were analyzed. The primary outcome was to assess the feasibility of a whole-gut exploration with CE. Sixteen (n = 16) studies including 915 CE procedures with CCE1 (n = 134), CCE2 (n = 357) and PCC (n = 424) were included. 13/16 studies were performed in the setting of Crohn’s disease. Cleanliness and completeness rates were acceptable in all studies, ranging from 63.9% and 68.6% to 100%, respectively. In conclusion, PCE is a feasible technique, although further structured studies are needed to explore its full potential.

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Pan-intestinal capsule endoscopy as first-line procedure in patients with suspected mid or lower gastrointestinal bleeding

Rosa,

Cúrdia Gonçalves,

Moreira

et al. 2024

Endoscopy

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Introduction: Pan-intestinal capsule endoscopy (PCE) evaluates the small-bowel and colon, non-invasively. Aim: To evaluate diagnostic accuracy and safety of PCE vs. colonoscopy as first-line examination in suspected mid-lower gastrointestinal bleeding (MLGIB). Methods: Prospective, single-centre, single-blinded cohort study. Consecutive patients with suspected MLGIB submitted to PCE followed by same-day colonoscopy. Diagnostic accuracy for potentially haemorrhagic lesions (PHL) (combined diagnosis by PCE + colonoscopy) and incidence of adverse events were assessed. Results: One-hundred patients included, mean age 66,5 [70 (18-92)] years, 65% females. PHL were diagnosed in 46% of patients, corresponding to small-bowel and/or colon angioectasias in 70%. PCE correctly identified individuals without PHL in 50%, identifying 96% (44/46) of all individuals with PHL, vs. 50% (23/46) for colonoscopy, p<0,01. PHL were detected by PCE-only in 65% (30/46), both examinations in 28% (13/46), and colonoscopy-only in 6% (3/46). PHL were diagnosed at the ileo-colonic territory in 28% of patients; in those cases, PCE established the diagnosis in 25/28 (89%) of cases, vs. conventional colonoscopy in 23/28 (82%), p=0,125. Interventional procedures were performed at colonoscopy in 13/81 patients with iron-deficiency anaemia (IDA) (16%) vs. 6/19 patients with overt bleeding (31,6%), p<0,01. No significant adverse events occurred with PCE vs. 2% with colonoscopy. Conclusions: While assessing patients with MLGIB, PCE dismisses further invasive procedures in more than half of patients. Moreover, PCE is safe and more effective than colonoscopy in identifying PHL both in the small-bowel and colon. Our results support the potential use of PCE as first-line examination in patients with suspected MLGIB.

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Pan-enteric capsule for bleeding high-risk patients. Can we limit endoscopies?

Cited by 8 publications

References 8 publications

Colon capsule for panendoscopy: a narrow window of opportunity

Colon capsule for panendoscopy: a narrow window of opportunity

Clinical feasibility of panintestinal (or panenteric) capsule endoscopy: a systematic review

Pan-intestinal capsule endoscopy as first-line procedure in patients with suspected mid or lower gastrointestinal bleeding

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