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PillCamColon2 after incomplete colonoscopy-A prospective multicenter study

World Journal of Gastroenterology 2018年第31期24卷 3556-3566页

作者： Peter Baltes Marc Bota Jorg Albert Michael Philipper Hans-Georg Horster Friedrich Hagenmüller Ingo Steinbrück Ralf Jakobs Matthias Bechtler Dirk Hartmann Horst Neuhaus Jean-Pierre Charton Rupert Mayershofer Horst Hohn Thomas Rosch Stefan Groth Tanja Nowak Peter Wohlmuth Martin Keuchel Clinic for Internal Medicine Bethesda Krankenhaus BergedorfHamburg 21029Germany Schwerpunktpraxis Gastroenterologie Koblenz 56068Germany Clinic for Interdisciplinary Endoscopy University Hospital EppendorfHamburg 20251Germany CorporateHealth International Hamburg 20149Germany Biometry and data management asklepios proresearchHamburg 20099Germany Department of Internal Medicine I Klinikum der JW.Goethe UniversitatFrankfurt 60590Germany Gastroenterologische Schwerpunktpraxis Düsseldorf 40227Germany gastropraxis rheydt Monchengladbach 41236Germany 1st Medical Department Asklepios Klinikum AltonaHamburg 22763Germany Medical Clinic C Klinikum der Stadt LudwigshafenLudwigshafen 67063Germany Clinic for Internal Medicine Sana Klinikum LichtenbergBerlin 10365Germany Clinic for Internal Medicine Evangelisches KrankenhausDüsseldorf 40217Germany Gastroenterologie am Burgweiher Bonn 53123Germany

AIM To evaluate the ability of PillCamColon2 to visualize colonic segments missed by incomplete optical colonoscopy(OC) and to assess the diagnostic *** This prospective multicentre study included 81 patients from nine centres who underwent second-generation colon capsule endoscopy(CCE) following incomplete OC performed by an experienced gastroenterologist(> 1000 colonoscopies). Patients with stenosis were excluded. According to patient preferences, CCE was performed the following day(protocol A) after staying on clear liquids and 0.75 L Moviprep in the morning or within 30 d after new split-dose Moviprep(protocol B). Boosts consisted of 0.75 L and 0.25 L Moviprep, and phospho-soda was given as a rescue if the capsule was not excreted after seven *** Seventy-four patients were analysed(51% of them in group A; 49% in group B). Bowel cleansing was adequate in 67% of cases, and CCE could visualize colonic segments missed by incomplete colonoscopy in 90% of patients under protocol A and 97% of patients under protocol B(P = 0.35, n.s.). Significant polyps including adenocarcinoma were detected in 24% of cases. Detection rates for all polyps and significant polyps per patient were similar in both protocols. Polyps were found predominantly in the right colon(86%) in segments that were not reached by OC. Extracolonic findings-such as reflux esophagitis, suspected Barrett esophagus, upper GI-bleeding, gastric polyps, gastric erosions and angiectasia-were detected in eight patients. Pill Cam Colon2 capsule was retained in the ileum of one patient(1.4%) without symptoms and removed during an uneventful resection for unknown Crohn's disease that was diagnosed as the cause of anemia, which was the indication for colonoscopy. CCE was well tolerated. One patient suffered from selflimiting vomiting after consuming the *** Second-generation CCE using a low-volume preparation is useful after incomplete OC, and it allows for the detection of add

关键词： Colon capsule endoscopy PillCamColon2 Incomplete colonoscopy Low volume prep Moviprep Phospho-soda Cleanliness level Complementation rate Polyps

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