Is colonic transit time a determining factor in diagnostic accuracy for Capsule Colonoscopy?

Aims The diagnostic accuracy of capsule colonoscopy (CC) may be influenced by factors such as the quality of bowel preparation or colonic transit time (CTT). Existing evidence is limited regarding how CTT affects diagnostic accuracy in CC. The aim of the study was to evaluate the influence of CTT on the detection of colorectal lesions.

Methods A retrospective single-center study of consecutive complete CCs performed in a Gastroenterology Department. Complete examination was defined as visualization of hemorrhoidal plexuses during battery time. Logistic regression adjusted for sex, age, and quality of bowel preparation was used to estimate the odds ratio in lesion detection in CC, using CTT as a categorical variable. Groups were defined based on CTT: group 1 (> 120 minutes), group 2 (61-120 minutes), and group 3 (≤ 60 minutes).

Results 226 examinations were included. The main reason for CC was previous incomplete conventional colonoscopy. The mean age was 63.5 years, 64.6% were women. The median CTT was 208.5 minutes. Group 1 included 166 examinations, 29 in group 2, and 31 in group 3. Detection of colorectal lesions (polyps, angiectasias, erosions, ulcers, and neoplasms) was significantly lower in group 3 compared to group 1 (OR 0.140, p<0.001) and group 2 (OR 0.184, p=0.005). No significant differences were observed between groups 1 and 2. Detection of polyps was significantly lower in group 3 (OR 0.271, p=0.007 vs group 1; OR 0.189, p=0.005 vs group 2). However, no statistically significant differences were found between the groups in detecting polyps≥6mm.

Conclusions In capsule colonoscopy with colonic transit time≤60 minutes, diagnostic accuracy may be limited. However, regarding diagnostic accuracy for polyps≥6mm, it appears to be independent of colonic transit time.

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Artikel online veröffentlicht:
27. März 2025