Therapeutic impact of colon capsule endoscopy with PillCam™ COLON 2 after incomplete standard colonoscopy: a Spanish multicenter study

• Óscar Nogales ^[1] ; Javier García-Lledó ^[1] ; Marisol Luján ^[2] ; David Nicolás ^[3] ; José Francisco Juanmartiñena ^[10] ; Begoña González-Suárez ^[11] ; Francisco Sánchez-Ceballos ^[4] ; Ignacio Couto ^[5] ; José Olmedo ^[6] ; Cristina Garfia ^[7] ; Cristina Carretero ^[8] ; Ignacio Fernández-Urién ^[10] ; Sarbelio Rodríguez ^[7] ; Matilde Asteinza ^[4] ; Pilar Olivencia ^[6] ; Ángeles Masedo ^[7] ; Miguel Muñoz-Navas ^[9] ; Beatriz Merino ^[1] ; Cecilia González-Asanza ^[1]
  1. [1] Hospital General Universitario Gregorio Marañón

     Hospital General Universitario Gregorio Marañón

     Madrid, España

     
  2. [2] Hospital General Universitario de Valencia

     Hospital General Universitario de Valencia

     Valencia, España

     
  3. [3] Hospital Universitario de Canarias

     Hospital Universitario de Canarias

     San Cristóbal de La Laguna, España

     
  4. [4] Hospital Clínico San Carlos de Madrid

     Hospital Clínico San Carlos de Madrid

     Madrid, España

     
  5. [5] Complexo Hospitalario Universitario da Coruña

     Complexo Hospitalario Universitario da Coruña

     A Coruña, España

     
  6. [6] Hospital General de Ciudad Real

     Hospital General de Ciudad Real

     Ciudad Real, España

     
  7. [7] Hospital Universitario 12 de Octubre

     Hospital Universitario 12 de Octubre

     Madrid, España

     
  8. [8] Clínica Universitaria de Navarra

     Clínica Universitaria de Navarra

     Pamplona, España

     
  9. [9] Universidad de Navarra

     Universidad de Navarra

     Pamplona, España

     
  10. [10] Hospital de Navarra. Pamplona, Spain
  11. [11] Hospital Clinic. Barcelona

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• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 109, Nº. 5, 2017, págs. 322-327
• Idioma: inglés
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• Resumen

  • Introduction: Colon capsule endoscopy (CCE) is an alternative approach for the examination of the colon in patients who refuse colonoscopy or after incomplete colonoscopy (IC). We conducted a study to determine the frequency of complete colonoscopy after IC, the diagnostic yield of CCE, the therapeutic impact of lesions found in CCE, the level of colon cleanliness and the safety of the procedure.

    Methods: We performed a prospective, multicenter study involving ten Spanish hospitals. Consecutive outpatients aged ≥ 18 years with previous IC were invited to participate. The latest version of the CCE device, PillCam™ COLON 2 (CCE-2), was administered to all patients according to the protocol.

    Results: The study population comprised 96 patients. The most frequent cause of IC was the inability to move past a loop using standard maneuvers (75/96 patients, 78%). Complete visualization of the colon was obtained with CCE-2 in 69 patients (71.9%). Of the 27 patients in whom the CCE-2 did not reach the hemorrhoidal plexus, it passed the colonic segment explored with the previous colonoscopy in 20 cases; therefore, it could be inferred that a combined approach (CCE-2 plus colonoscopy) enabled complete visualization of the colonic mucosa in 92.7% of patients.

    CCE-2 revealed new lesions in 58 patients (60.4%). Polyps were the most frequent finding (41 patients; 42.7% of the total number of patients). In 43 of the 58 patients (44.8% of the total number of patients), the new lesions observed led to modification of therapy, which included a new colonoscopy for polyp resection or surgery in patients with colonic neoplasm.

    Conclusions: CCE-2 is a suitable diagnostic procedure that can lead to more frequent diagnosis of significant colonic lesions after IC.