Panenteric Capsule as an alternative to colonoscopy. Could we avoid unnecessary colonoscopies? Preliminary results

Aims The Panenteric Capsule Endoscopy (PCE) allows a non-invasive evaluation of the colon as an alternative to colonoscopy (CC), enabling the detection of lesions also in the small bowel (SB).

Aims: 1. To assess the percentage of patients who could avoid a CC after a PCE. 2. To evaluate the diagnostic yield of PCE in the colon and SB. 3. To evaluate the role of PCE in prioritizing patients in the waiting list. 4. To compare the findings of PCE and CC.

Methods A prospective and multicentre study is ongoing in 3 referral centres in Spain. An intermediate analysis has been conducted between December 2021 and October 2024. Patients scheduled for a non-urgent CC were included. A PillCam Crohn’s Capsule (Medtronic, Dublin, Ireland) was administered prior to the CC. Based on findings the CC prioritization was determined (within<30 days).

Results A total of 1805 patients were invited to participate in the study, and 941 of them accepted (52,1%). After an initial visit, 523 PCE (29%) procedures were performed. For this intermediate analysis, 470 patients, who had both PCE and CC completed, were analyzed. Our population included 285 males (60,6%), with a mean age of 59±10,2 years old. The most frequent indication was polyp surveillance (38,9%), followed by family history of colorectal cancer (17%) and rectal bleeding (9,6%). Excretion capsule rate was 80% and adequate cleansing rate 82,1%. CC identified 98 patients (20,9%) with significant findings, while PCE identified 138 (29,4%). In 14 patients (2,9%), lesions were only identified by CC (PCE was incomplete in 6 cases, there was an inadequate cleansing in 3 studies and 5 were serrated polyps). PCE sensitivity, specificity, PPV and NPV were 85,1%, 84,5%, 60,2% and of 95,4%, respectively. CC was prioritized in 49 patients (10.4%), including2 CRC cases. PCE identified also lesions in the SB in 194 patients (41.3%). Adverse events rate was 3.8% (all mild) for PCE and 0.2% for CC due to 1 SAE.

Conclusions Based on our preliminary results, PCE could prevent unnecessary colonoscopies and enable their prioritization.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025