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Background: Colon capsule endoscopy (CCE) is an innovative, safe and noninvasive endoscopic technique for the diagnosis of colorectal diseases without the need of sedation. Aims: To evaluate the accuracy and safety of the second generation CCE in diagnosing colorectal polyps. Methods: In a prospective study, 32 patients who were diagnosed as having colorectal polyps (defined as at least one polyp of 6 mm or larger in diameter; or three or more polyps of any size) by colonoscopy from Jan. 2014 to Sep. 2015 at the Xijing Hospital were enrolled. Colonoscopic polypectomy was performed on the second day of CCE. Taking the finding of therapeutic colonoscopy as gold standard, the sensitivity of CCE in diagnosing colorectal polyps was evaluated. Furthermore, the colonic cleansing, the transit time and excretion rate of the capsule, as well as the CCE-related adverse events were assessed. Results: In one patient, no polyp was found under the therapeutic colonoscopy. CCE detected the polyps in 27 of 31 patients, the per-patient sensitivity was 87% (95% CI: 69%-96%). The sensitivity of CCE in detecting polyps ≥10 mm, ≥6 mm and ≤5 mm in diameter were 82% (95% CI: 48%-97%), 76% (95% CI: 54%-90%), and 66% (95% CI: 53%-77%), respectively. The overall cleanliness was adequate in 71% (95% CI: 51%-87%) of the patients. The mean gastrointestinal transit time of the capsule was (11.42±5.23) hours, and the mean colonic transit time was (7.47±4.75) hours. The capsule excretion rate within the battery life was 75%. There were no adverse events related to CCE. Conclusions: The second generation CCE is safe and has a potential value in diagnosing colorectal polyps. The sensitivity in detecting polyps of 10 mm and 6 mm or larger in diameter is fairly well.
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Objective@#To explore the clinical applications of second generation colon capsule endoscopy (CCE-2).@*Methods@#From July 2017 to December 2018, at the First Affiliated Hospital, College of Medicine, Zhejiang University, 40 outpatients and hospitalized patients who underwent CCE-2 examination were enrolled. The examination results were analyzed by an expert gastroenterologist with rich experience in small intestinal and colon capsule endoscopy. The stomach, small bowel and colon transit time, the score of colon cleansing quality, the completion rate of colon capsule examination, lesion detection and adverse effects were observed. Chi-square test and Student′t test were used for statistical analysis.@*Results@#The whole gastrointestinal tract examination was completed during the capsule running time in 65.0% (26/40) of the patients. The average stomach transit time was (0.92±0.74) h, the small bowel transit time was (3.93±1.51) h and the colon transit time was (4.89±0.61) h. The capsule running time of patients who completed the whole gastrointestinal tract examination was shorter than that of patients who did not complete the whole gastrointestinal tract examination ((9.44 ± 3.53) h vs. (15.47±2.09) h), and the difference was statistically significant (t=6.79, P<0.01). The qualified rate of colon preparation was 67.5% (27/40). There were no statistically significant differences in colon transit time or capsule excretion time between patients with qualified colon preparation and poor colon preparation ((4.43±3.33) h vs. (5.96 ± 2.44) h; and (9.06 ± 3.91) h vs. (10.29±2.47) h; t=1.17 and 0.81, both P>0.05). A total of 33 (82.5%) patients had gastrointestinal lesions detected by colon capsule, including three cases of esophageal lesions (inflammation and mass), 21 cases of gastric lesions (chronic gastritis, mucosal protrusion, polyp and ulcer), nine cases of small bowel lesions (polyp, ulcer and vascular malformation) and 19 cases of colonic lesions (diverticulum, polyp, rectitis, mucosal erosion, ulcer and vascular malformation, internal hemorrhoids). Among them, there were 11 patients with two or more lesions. No adverse events occurred during the examination and all the capsules were excreted within 48 hours.@*Conclusion@#CCE-2 with high safety and good tolerance can be used for whole gastrointestinal tract examination.
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Introducción: La cápsula colónica, PillCam© Colon fue utilizada por primera vez en el mundo en octubrede 2006 para la exploración no invasiva del colon. Estudios recientes han demostrado su buena rentabilidaddiagnóstica, comparada con la colonoscopía convencional, en el estudio de la patología colónica.Objetivo: Determinar el rendimiento diagnóstico de la PillCam© Colon en la detección de lesiones colónicas,comparada con la colonoscopia convencional, en pacientes de la ciudad de Cartagena con sintomatología de los intestinos medio y bajo. Materiales y métodos: Estudio observacional, prospectivo de pruebas diagnósticas, en el cual se evaluóla validez (la sensibilidad, la especifi cidad y los valores predictivos) de la PillCam© Colon, comparada con lacolonoscopia, en la detección de lesiones colónicas, en una cohorte de pacientes que consultaron a la clínicaUniversitaria San Juan de Dios por sintomatología de los intestinos medio y bajo en Cartagena, durante elperiodo junio de 2011-enero de 2013. Los análisis se realizaron utilizando el software STATA 11.0.Resultados: Se estudió a 25 pacientes: 14 mujeres (56%) y 11 hombres (44%); todos ellos, con colonoscopiaprevia, y a quienes se les practicó una panendoscopia con la PillCam© Colon activada. Se logró la exploración completa del colon en el 76% de los casos (19 pacientes). El tiempo del tránsito colónico fue de 2,4 horas (DE±1,3 horas), y el del tránsito oroanal, de 6,2 horas (DE± 1,18). Conclusión: La PillCam© Colon es una técnica no invasiva, altamente sensible y segura en la detección delesiones colónicas, y que puede ser de utilidad en la práctica clínica en grupos de alto riesgo para la deteccióntemprana del cáncer colorrectal y en los casos donde la colonoscopia sea incompleta o esté contraindicada.
Introduction: In October 2006 the PillCam© Colon colonic capsule was used for the fi rst time ever for noninvasive colon. Recent studies have shown that is diagnostic performance is good in comparison with conventional colonoscopy for the study of colonic pathologies.Objective: The objective of this study was to compare the diagnostic yield of PillCam© Colon in detecting colonic lesions with the yield of conventional colonoscopy for patients with symptoms in the mid and lowerintestinal regions in a hospital in Cartagena. Materials and methods: This was a prospective observational study of diagnostic tests which assessed the validity (sensitivity, specifi city and predictive values ) of the PillCam© Colon and compared them with colonoscopy for the detection of colonic lesions in a cohort of patients at the University Clínica Universitaria San Juan de Dios in Cartagena. Patients had symptoms in the mid and lower intestinal regions. Patients were examined from June 2011 to January 2013. Analyses were performed using STATA 11.0 software.Results: We studied 25 patients: 14 women (56 %) and 11 men (44 %). All had previously undergonecolonoscopies. Panendoscopies were performed on these patients using an activated PillCam© Colon. Weachieved complete colon examinations in 76% (19 patients). Colonic transit time was 2.4 hours (SD ± 1.3hours) and oral-anal transit time was 6.2 hours (SD ± 1.18). 78.9% of the fi ndings of the PillCam© Colon andcolonoscopy agreed. Conclusion: PillCam© Colon is a highly sensitive and reliable non-invasive method for detection of lesionsin the colon. It may be useful in clinical practice for early detection of colorectal cancer in high risk groups and in cases that colonoscopy is incomplete or contraindicated.
Subject(s)
Humans , Male , Female , Angiodysplasia , Colon , Colonoscopy , Diverticulum , PolypsABSTRACT
Objective To investigate diagnostic value of colon capsule endoscopy (CCE) for mucosal lesions of patients with active ulcerative colitis. Methods A total of 19 consecutive patients, including 12 males and 7 females, were enrolled from July 2009 to June 2010, with a mean age at 44. 16 + 14.64.Dominant symptoms were hematochezia, diarrhea and abdominal pain, consistent with the criteria of ulcerative colitis. All cases were scored into 3 grades according to severity of mucosal lesions. Using conventionalcolonoscopic findings as golden standard, the consistence of mucosal classification of CCE was calculated with kappa- and P-value. Meanwhile, related data such as the rate of completion, colonic cleanliness and adverse reactions were also collected and analyzed. Results CCE revealed that mild, moderate and severe cases were 2, 8 and 9, respectively, while the 3 types shown by conventional colonoscopy were 3, 8 and 8,respectively. Kappa-value was 0. 826 and P-value was less than 0. 001, which indicated good consistence. In addition, the completion rate of CCE and excellent/fine rate of the colonic cleanliness were 100% (19/19)and 79% ( 15/19), respectively. There were no adverse reactions recorded. Conclusion With high diag-nostic consistency to conventional colonoscopy in classification of mucosa severity, CCE precisely reveals the mucosal lesions of ulcerative colitis and becomes a potential alternative to partially replace conventional colonoscopy, especially in surveillance.