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 11 publications

(23 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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What Is the Optimal Bowel Preparation for Capsule Colonoscopy and Pan-intestinal Capsule Endoscopy? A Systematic Review and Meta-Analysis

Rosa,

Donato,

Cúrdia Gonçalves

et al. 2023

Dig Dis Sci

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Background The rate of adequate cleansing (ACR) and complete examinations (CR) are key quality indicators in capsule colonoscopy (CC) and pan-intestinal capsule endoscopy (PCE). Aims To evaluate the efficacy of bowel preparation protocols regarding ACR and CR. Methods We conducted a systematic review and meta-analysis, search terms regarding colon capsule preparation, publication date from 2006/01, and date of search 2021/12, in six bibliographic databases. Multiple steps of the cleansing protocol were assessed: diet, adjunctive laxatives, purgative solution, use of prokinetic agents, and "booster". The meta-analytical frequency of ACR and CR was estimated, and subgroup analyses performed. Strategies associated with higher ACR and CR were explored using meta-analytical univariable and multivariable regression models. Results Twenty-six observational studies and five RCTs included (n = 4072 patients). The pooled rate of ACR was 72.5% (95% C.I. 67.8-77.5%; I 2 = 92.4%), and the pooled rate of CR was 83.0% (95% C.I. 78.7-87.7%; I 2 = 96.5%). The highest ACR were obtained using a low-fibre diet [78.5% (95% C.I. 72.0-85.6%); I 2 = 57.0%], adjunctive laxatives [74.7% (95% C.I. 69.8-80.1%); I 2 = 85.3%], and split dose < 4L polyethylene glycol (PEG) as purgative [77.5% (95% C.I. 68.4-87.8%); I 2 = 47.3%]. The highest CR were observed using routine prokinetics prior to capsule ingestion [84.4% (95% C.I. 79.9-89.2%); I 2 = 89.8%], and sodium phosphate (NaP) as "booster" [86.2% (95% C.I. 82.3-90.2%); I 2 = 86.8%]. In univariable models, adjunctive laxatives were associated with higher ACR [OR 1.81 (95% C.I. 1.13; 2.90); p = 0.014]. CR was higher with routine prokinetics [OR 1.86 (95% C.I. 1.13; 3.05); p = 0.015] and split-dose PEG purgative [OR 2.03 (95% C.I. 1.01; 4.09), p = 0.048]. Conclusions Main quality outcomes (ACR, CR) remain suboptimal for CC and PCE. Despite considerable heterogeneity, our results support low-fibre diet, use of adjunctive sennosides, split dose < 4L PEG, and routine prokinetics, while NaP remains the most consistent option as booster.

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

Cited by 11 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

What Is the Optimal Bowel Preparation for Capsule Colonoscopy and Pan-intestinal Capsule Endoscopy? A Systematic Review and Meta-Analysis

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