Feasibility of patency capsule and colon capsule endoscopy in patients with suspected gastrointestinal stenosis: a prospective study

ABSTRACT Patency capsule (PC) can evaluate the patency of gastrointestinal (GI) tract. We hypothesized preceding patient selection using PC would improve the successful rate of colon capsule endoscopy (CCE). Therefore, a prospective single-arm study using PC followed by CCE was conducted with a control group of CCE alone. Patients with suspected or known GI stenosis scheduled for CCE were enrolled. CCE was performed only when the PC was excreted out of the body within 33 hours of ingestion. Primary endpoint was the rate of observation of the entire GI tract within the duration of examination. The secondary endpoints were complications and CCE findings. Twenty-three patients (17 men) were enrolled. The mean age was 50.5±19.8 years. Suspected stenotic sites were 8, 5, and 10 in the small, large, and small and large bowel, respectively. Sixteen, 12, and 10 patients had abdominal pain, active inflammatory bowel disease, and history of surgery for suspected stenosis, respectively. Patency of GI tract was confirmed in 96% (22/23) of the patients by administered PC. Of the 22 patients who underwent CCE, the entire GI tract was observed in 86% (19/22). No complications were observed. The median transit times in the small bowel and colon were 99 (21–682) and 160 (5–328) minutes, respectively. CCE findings revealed ulcers, erosions, and diverticula in 5, 9, and 4 patients, respectively. In conclusion, CCE with PC might be a safer and useful modality to observe the large colon for patients with suspected GI stenosis.

[1]  T. Matsui,et al.  Tag‐less patency capsule for suspected small bowel stenosis: Nationwide multicenter prospective study in Japan , 2020, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[2]  N. Hotta,et al.  Clinical Factors Associated with Missing Colorectal Polyp on Colon Capsule Endoscopy , 2019, Digestion.

[3]  H. Yatsuya,et al.  Multicenter feasibility study of bowel preparation with castor oil for colon capsule endoscopy , 2018, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[4]  G. Costamagna,et al.  Evaluation of a new pan-enteric video capsule endoscopy system in patients with suspected or established inflammatory bowel disease – feasibility study , 2018, Endoscopy International Open.

[5]  W. Leung,et al.  Colon capsule endoscopy for inflammatory bowel disease , 2018, Journal of digestive diseases.

[6]  Y. Hirooka,et al.  Clinical significance of gastrointestinal patency evaluation by using patency capsule in Crohn’s disease , 2018, Nagoya journal of medical science.

[7]  R. Eliakim The impact of panenteric capsule endoscopy on the management of Crohn’s disease , 2017, Therapeutic advances in gastroenterology.

[8]  Per-Ola Park,et al.  Colonic obstruction caused by video capsule entrapment in a metal stent. , 2017, Annals of translational medicine.

[9]  A. Castells,et al.  Twelve-year asymptomatic retention of a colon capsule endoscope. , 2017, Gastrointestinal endoscopy.

[10]  Y. Hirooka,et al.  Prospective study of factors important to achieve observation of the entire colon on colon capsule endoscopy , 2016, Therapeutic advances in gastroenterology.

[11]  J. Romero-Vázquez,et al.  Extracolonic findings with the PillCam Colon: is panendoscopy with capsule endoscopy closer? , 2016, Endoscopy International Open.

[12]  Y. Yılmaz,et al.  Diagnostic Role of Colon Capsule Endoscopy in Patients with Optimal Colon Cleaning , 2016, Gastroenterology research and practice.

[13]  E. Seidman,et al.  Use of patency capsule in patients with established Crohn’s disease , 2015, Endoscopy.

[14]  D. McNamara,et al.  PillCam COLON 2(©) as a pan-enteroscopic test in Crohn's disease. , 2015, World journal of gastrointestinal endoscopy.

[15]  K. Utano,et al.  Gastrografin as an alternative booster to sodium phosphate in colon capsule endoscopy: safety and efficacy pilot study* , 2015, Endoscopy International Open.

[16]  P. Kashyap,et al.  Polyethylene glycol plus an oral sulfate solution as a bowel cleansing regimen for colon capsule endoscopy: a prospective, single-arm study in healthy volunteers , 2015, Therapeutic advances in gastroenterology.

[17]  D. Franchimont,et al.  Safety and Feasibility of Using the Second-Generation Pillcam Colon Capsule to Assess Active Colonic Crohn's Disease. , 2015, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[18]  F. Dias de Castro,et al.  PillCam COLON 2 in Crohn's disease: A new concept of pan-enteric mucosal healing assessment. , 2015, World journal of gastroenterology.

[19]  L. Gerson,et al.  Is colon capsule endoscopy ready for prime time? , 2014, Gastroenterology.

[20]  D. Rex,et al.  A grading scale to evaluate colon cleansing for the PillCam COLON capsule: a reliability study. , 2011, Endoscopy.

[21]  C. Fraser,et al.  Safety, Reliability and Limitations of the Given Patency Capsule in Patients at Risk of Capsule Retention: A 3-Year Technical Review , 2008, Digestive Diseases and Sciences.

[22]  G. Costamagna,et al.  Video Capsule Endoscopy in Patients With Known or Suspected Small Bowel Stricture Previously Tested With the Dissolving Patency Capsule , 2007, Journal of clinical gastroenterology.

[23]  Amy K Hara,et al.  A Meta-Analysis of the Yield of Capsule Endoscopy Compared to Other Diagnostic Modalities in Patients with Non-Stricturing Small Bowel Crohn's Disease , 2006, The American Journal of Gastroenterology.