Effect of capsule placement with transnasal endoscopy.

AIM: One of the prohibiting factors in achieving complete small bowel capsule endoscopy is slow gastric transit of the capsule. The present study retrospectively investigated the success rate of, and the time required for, transnasal endoscope-assisted capsule placement to assess its clinical utility. METHODS: In 24 of 27 patients who underwent capsule placement assisted by a transnasal endoscope, the capsule was successfully transported to and released in the duodenum (capsule placement group). For each patient in the capsule placement group, three age- and sex-matched patients who underwent conventional capsule endoscopy were assigned as controls (n=72). Gastric transit time, small bowel transit time, and rate of capsule arrival at the cecum within 8h were compared between the two patient groups. RESULTS: Among the 27 patients in whom capsule placement was carried out, the capsule was successfully placed in the duodenum in 24 patients (88.9% success rate). In the capsule placement group, gastric transit time was significantly shorter (10.5 vs 46.2min, P=0.0021), small bowel transit time was significantly longer (354.7 vs 301.3min, P=0.0134), and completion rate (capsule arrival at the cecum within 8h) was significantly higher (83.3 vs 61.1%, P=0.0455) than in the control group. There were no procedural accidents associated with capsule placement. CONCLUSION: Transnasal endoscope-assisted capsule placement appears to be a safe and reliable procedure, achieving complete small bowel capsule endoscopy, and is considered clinically useful.

Correlations between obesity/metabolic syndrome-related factors and risk of developing colorectal tumors.

BACKGROUND/AIMS: Colorectal cancer/adenoma development may correlate with obesity/metabolic syndrome in the Japanese. We sought to clarify the relation between colorectal adenoma prevalence and various factors to develop a better colorectal tumor screening strategy. METHODOLOGY: Of 2668 patients who underwent colonoscopy, medical records of 837 patients (467 men, 370 women; age, 40-80 years) with available data on measured values of body mass index, waist circumference, body fat percentage, and prior history of hypertension, diabetes and hyperlipidemia were reviewed and analyzed. RESULTS: Of these patients, 460 (55.0%) had colorectal tumor or prior history thereof (lesions >=1mm). Multivariate analysis revealed significant differences in gender, age and waist circumference between patients with/without colorectal adenoma, with men at significantly higher risk than women of developing colorectal tumor (OR=2.57, 95% CI: 1.84-4.65; p<0.001). In patients with/without colorectal tumor, age, waist circumference and body fat percentage were significantly different among men, but only age was significantly different among women. CONCLUSIONS: Present findings that waist circumference and body fat percentage correlated with prevalence of colorectal tumor among men may contribute to more accurate prediction of colorectal tumor risk and an efficient colorectal cancer screening system.