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DOI: 10.1055/s-0039-1681198
CAPSULE RETENTION IN CROHN DISEASE: A META-ANALYSIS
Publication History
Publication Date:
18 March 2019 (online)
Aims:
To evaluate capsule retention rates in adult and pediatric Crohn disease (CD) and determine if retention risk can be reduced in established CD (ECD) with patency capsule (PC) or dedicated small bowel (SB) cross sectional imaging (MR/CT enterography) using meta-analysis.
Methods:
Publications were identified in MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Web of Science for studies of CD patients undergoing capsule endoscopy (CE) that reported retention. The retention rate and relative risk (RR) of retention in ECD to suspected CD (SCD) was estimated for each study. The pooled estimates for the various capsule retention rates and for RR were also calculated. All hypothesis tests were two-sided with p < 0.05 considered statistically significant.
Results:
Retention rates were 0.03 (95% CI 0.03 – 0.04) in the overall CD cohort, 0.05 (95% CI 0.03 – 0.06) in ECD, and 0.02 (95% CI 0.01 – 0.04) in SCD. The retention rates in adult and pediatric studies were 0.03 (95% CI 0.03 – 0.04) and 0.02 (95% CI 0.01 – 0.04), respectively. Retention risk in adult ECD was 3.50 times higher than SCD (95% CI 2.12 – 5.78). There was no difference in retention risk in pediatric ECD compared with SCD (RR 4.92; 95% CI 0.80 – 30.08). Retention rates in ECD were decreased to 0.02 (95% CI 0.01 – 0.06) after cross-sectional imaging, and 0.03 (95% CI 0.02 – 0.05) after negative PC.
Conclusions:
Our meta-analysis shows lower CE retention rates in both SCD and ECD compared to older literature. The retention rate in adult ECD was significantly higher than adult SCD. In patients with ECD, retention rates were lower after negative PC or cross-sectional imaging. Retention rates in pediatric CD were lower than adult CD, and in contrast to adults, there was no difference in retention rates between pediatric ECD and SCD.