Endoscopic GI placement of capsule endoscopy to investigate the small bowel: a multicenter European retrospective series of 630 procedures in adult patients

Ouazana, Salome; Baltes, Peter; Toth, Ervin; Lüttge, Hannah; Nemeth, Artur; Beaumont, Hanneke; González-Suárez, Begoña; Lee, Phey Shen; Carretero, Cristina; Margalit Yehuda, Reuma; Elli, Luca; Spada, Cristiano; Bruno, Mauro; Mussetto, Alessandro; Cortegoso Valdivia, Pablo; Becq, Aymeric; Corbett, Gareth; Martin, Antoine; Robertson, Alexander; Benamouzig, Robert; Despott, Edward; Riccioni, Maria Elena; Sidhu, Reena; Calavas, Laura; Ellul, Pierre; Finta, Adam; Triantafyllou, Konstantinos; Rondonotti, Emanuele; Kirchgesner, Julien; Elosua, Alfonso; McNamara, Deirdre; Dray, Xavier

doi:10.1016/j.gie.2024.01.027

Cited by 1 publication

(2 citation statements)

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“…Furthermore, in a setting of low incidence of incomplete SBCEs, E846 the economic impact of capsule endoscopic placement would be negligible; moreover, the cost analysis would vary significantly according to the organization of the endoscopic unit (e. g., on-call endoscopic team, dedicated room). However, a recent multicenter retrospective analysis of a large cohort of adult patients showed that capsule endoscopic placement has very good outcomes in terms of feasibility, safety, and completion rate, specifically with capsule delivery in the duodenum [21].…”

Section: Discussionmentioning

confidence: 99%

“…However, a recent multicenter retrospective analysis on a large cohort of adult patients showed that capsule endoscopic placement has very good outcomes in terms of feasibility, safety, and completion rate, specifically with the capsule delivery in the duodenum. [21] Looking beyond the need for risk stratification, this study identified low battery life as an overlooked risk factor for incomplete SBCE, whose impact could be particularly relevant in high-volume centres. Remarkably, among the incomplete SBCEs observed in our cohort (46/858, 5.4%), we identified a suboptimal registration time in over a quarter of SBCEs (12/46, 26.1%) because of a battery life <9 hours.…”

Section: Accepted Manuscriptmentioning

confidence: 91%

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Incomplete small bowel capsule endoscopy: Risk factors and cost-effectiveness of real-time viewing

Topa,

Rimondi,

Sorge

et al. 2024

Endosc Int Open

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Aims. International guidelines recommend real-time viewing (RTV) in capsule endoscopy for gastric emptying monitoring, yet it is often overlooked in clinical practice. We aim to assess risk factors for incomplete small bowel capsule endoscopy (SBCE) and evaluate the clinical relevance and cost-effectiveness of RTV implementation. Methods. We included consecutive SBCEs from 2013 to 2020. RTV was not applied per local protocol. We used multivariate logistic regression to identify risk factors for incomplete SBCE, including prolonged gastric transit time (GTT) and prolonged small bowel transit time (SBTT). Results. Analysing 858 SBCEs, we observed a completion rate of 94.6%. Prolonged GTT and SBTT were present in 4.9% and 18.2% of complete SBCEs, and in 13% (p=0.03) and 10.8% (p=0.24) of incomplete SBCEs, respectively. Only 0.7% (6 out of 858) had incomplete SBCE with prolonged GTT. In both univariate and multivariate analysis, a modifiable (prolonged GTT [OR 2.9; 95% CI 1.1-7.5]) and two unmodifiable risk factors (inpatient status [OR 2.3; 95% CI 1.1–4.5] and history of incomplete SBCE [OR 4.2; 95% CI 1.3-13.7]) were independently linked to higher incomplete SBCE rates. The pretest completion probability was 90.5% and 95.8% in patients with and without unmodifiable risk factors, respectively (p<0.01). The direct cost of systematic RTV adoption and prokinetics administration would be €5059, aiming to identify and treat each case of prolonged GTT associated with incomplete SBCE. Conclusions. Modern devices make incomplete SBCE rare, usually not tied to prolonged GTT. In a low-incidence scenario, widespread RTV use brings high costs and uncertain effectiveness.

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Section: Discussionmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 91%