Endoscopy 2012; 44(10): 911-916
DOI: 10.1055/s-0032-1310008
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Prospective multicenter evaluation of colon capsule examination indicated by colonoscopy failure or anesthesia contraindication

M. Pioche
1   Department of Gastroenterology, Hôpital Edouard Herriot, Lyon, France
,
A. de Leusse
1   Department of Gastroenterology, Hôpital Edouard Herriot, Lyon, France
,
B. Filoche
2   Service d’Hépato-Gastroentérologie, Hôpital Saint Philibert, Lomme, France
,
P. A. Dalbiès
3   Gastroenterology practice, Béziers, France
,
P. Adenis Lamarre
4   Department of Gastroenterology, Clinique Poitiers, Poitiers, France
,
P. Jacob
5   Gastroenterology practice, Nîmes, France
,
J. L. Gaudin
6   Department of Gastroenterology, Clinique Val-d’Ouest, Lyon, France
,
P. Coulom
7   Department of Gastroenterology, Clinique Saint-Jean Languedoc, Toulouse, France
,
J. C. Letard
8   Department of Hepatogastroenterology, Polyclinique de Poitiers, Poitiers, France
,
E. Borotto
9   Department of Gastroenterology and Hepatology, Centre hospitalier privé St Martin, Caen, France
,
A. Duriez
10   Gastroenterology, Centre hospitalier de Roubaix, France
,
J.-M. Chabaud
11   Gastroenterology practice, Anglet, France
,
D. Crampon
12   Department of Gastroenterology, Pôle Santé République, Clermont-Ferrand, France
,
R. Gincul
1   Department of Gastroenterology, Hôpital Edouard Herriot, Lyon, France
,
P. Levy
13   Department of Gastroenterology Centre d’endoscopie, Strasbourg, France
,
E. ben-Soussan
14   Department of Gastroenterology, Rouen University Hospital, Rouen, France
,
M. Garret
15   Department of Gastroenterology, Centre hospitalier Pierre Dezarnaulds, Gien, France
,
J. Lapuelle
6   Department of Gastroenterology, Clinique Val-d’Ouest, Lyon, France
,
J. C. Saurin
1   Department of Gastroenterology, Hôpital Edouard Herriot, Lyon, France
,
SFED (Société Française d’Endoscopie Digestive; French Society of Digestive Endoscopy), CREGG (Club de Réflexion des Cabinets de Groupe de Gastroentérologie; French association of gastroenterologists in private practice) › Author Affiliations
Further Information

Publication History

submitted 29 March 2012

accepted after revision 10 May 2012

Publication Date:
14 August 2012 (online)

Background and study aims: In France, in about 5 % of cases colonoscopies are incomplete or temporarily contraindicated. We tested the diagnostic yield of colon capsule endoscopy (CCE) in these patients.

Patients and methods: In a prospective study, in 17 French centers, inclusion criteria were colonoscopy failure or general disease that excluded colonoscopy with anesthesia. Patients underwent CCE using the first-generation PillCam Colon capsule. The main end point was CCE diagnostic yield, defined as identification of a colorectal lesion that directly explained symptoms or necessitated a diagnostic or therapeutic examination. A secondary objective was to test a simplified MoviPrep colon cleansing. Follow-up to identify missed symptomatic cancer was scheduled.

Results: CCE showed positive findings in 36 patients (diagnostic yield 33.6 %), among whom 23 subsequently underwent therapeutic intervention. Among 64 patients with negative capsule findings, 9 had a complementary procedure showing adenomas in only 1 case. CCE was incomplete in 7/107 patients. Colonoscopy was done in one patient to retrieve a capsule retained in the left colon, and sigmoidoscopy in 11 because the rectum was not reached. No colorectal cancer was diagnosed during the follow-up period. Colon cleansing with MoviPrep was rated good or excellent in 75.9 % of cases.

Conclusion: This study shows the feasibility and the usefulness of CCE in the situation of colonoscopy failure or contraindication. The colon capsule modality should be tested against other available approaches, such as virtual colonoscopy or repeat colonoscopy by an expert.

 
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