Applicability of Colon Capsule Endoscopy as Pan-Endoscopy: From Bowel Preparation, Transit Times and Completion Rate to Rating Times and Patient Acceptance

Colon capsule for panendoscopy: a narrow window of opportunity

“…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].…”

“…The technical barriers that had initially prevented the exploration of the entire surface of the digestive system have been removed over time through the development of batteries with longer life, the optimization of power consumption (e. g., through the adaptive frame rate) and the increase in the number of cameras and in the angle of view (to cover the entire mucosal surface of wider lumen organs). The study by Vuik et al [2] in the current issue of Endoscopy International Open, as well as several other publications, [3] confirm that the endoscopic study of the entire surface of the digestive system appears to be now technically possible.…”

“…This is likely to have even greater relevance in the field of wireless endoscopy, where the capsule is purely passive (e. g., it cannot wash or remove debris) and bowel preparation also plays a key role in promoting device propulsion. In the paper from Vuik et al [2] the rate of patients with adequate colon cleansing (76.6 %) was below the ≥ 90 % minimum standard recommended for optical colonoscopy [6], although involved subjects were healthy and highly compliant with the preparation schedule (93.6 % of them took the entire bowel preparation). Although this may reflect the specific preparation schedule adopted in the study, a recent systematic review [3] showed that the rate of patients with adequate colon cleansing was highly variable, but ≥ 90 % in only 54 % of studies, even when different schedules were used.…”

“…Patient acceptability has always been emphasized as one of the major advantages of capsule endoscopy over more invasive and less tolerated procedures, such as gastroscopy and colonoscopy. However, Vuik et al [2] demonstrated that moving from theory (pre-procedural questionnaire) to practice (postprocedural questionnaire), patient expectations are somewhat disregarded. In line with these results, in the TOPAZ study [12] more subjects who underwent both procedures under evaluation unexpectedly preferred traditional colonoscopy over colon capsule endoscopy.…”