Clin Endosc.  2021 Jan;54(1):92-99. 10.5946/ce.2020.049.

Colon Capsule Endoscopy: Indications, Findings, and Complications – Data from a Prospective German Colon Capsule Registry Trial (DEKOR)

Affiliations
  • 1Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt am Main, Germany
  • 2Department of Internal Medicine, St. Vinzenz-Hospital, Hanau, Germany
  • 3Gastroenterologische Facharztpraxis, Düsseldorf, Germany
  • 4Gastroenterologische Praxis Dr. Gero Moog, Kassel, Germany
  • 5Gastroenterologische Praxis Dr. Horst Hohn, Koblenz, Germany
  • 6Endoskopiezentrum Dr. Norbert Hesselbarth, Schwalmstadt, Germany
  • 7Centrum für ambulante Gastroenterologie, Nürnberg, Germany
  • 8Gastroenterologie, Hepatologie und Endokrinologie, Robert-Bosch-Krankenhaus, Stuttgart, Germany

Abstract

Background/Aims
Reliable and especially widely accepted preventive measures are crucial to further reduce the incidence of colorectal cancer (CRC). Colon capsule endoscopy (CCE) might increase the screening numbers among patients unable or unwilling to undergo conventional colonoscopy. This registry trial aimed to document and determine the CCE indications, findings, complications, and adverse events in outpatient practices and clinics throughout Germany.
Methods
Patients undergoing CCE between 2010 and 2015 were enrolled in this prospective multicenter registry trial at six German centers. Patient demographics, outcomes, and complications were evaluated.
Results
A total of 161 patients were included. Of the CCE evaluations, 111 (68.9%) were considered successful. Pathological findings in the colon (n=92, 60.1%) and in the remaining gastrointestinal tract (n=38, 24.8%) were recorded. The main finding was the presence of polyps (n=52, 32.3%). Furthermore, five carcinomas (3.1%) were detected and histologically confirmed later. Adequate bowel cleanliness was more likely to be achieved in the outpatient setting (p<0.0001). Interestingly, 85 patients (55.6%) chose to undergo CCE based on personal motivation.
Conclusions
CCE seems to be a reliable and safe endoscopic tool for screening for CRC and detecting other diseases. Its patient acceptance and feasibility seems to be high, especially in the outpatient setting.

Keyword

Colonic neoplasms; Control; Endoscopy; Prevention; Registries; Safety

Figure

  • Fig. 1. Overview of the pathological findings of colon capsule endoscopy. (A) Crohn’s disease of the jejunum. (B) Colon polyp. (C) Colon carcinoma. (D) Close-up view of colon carcinoma.


Cited by  1 articles

Colon Capsule Endoscopy: An Alternative for Conventional Colonoscopy?
Britt B.S.L. Houwen, Evelien Dekker
Clin Endosc. 2021;54(1):4-6.    doi: 10.5946/ce.2021.047.


Reference

1. Welch HG, Robertson DJ. Colorectal cancer on the decline--why screening can’t explain it all. N Engl J Med. 2016; 374:1605–1607.
2. Ryerson AB, Eheman CR, Altekruse SF, et al. Annual report to the nation on the status of cancer, 1975-2012, featuring the increasing incidence of liver cancer. Cancer. 2016; 122:1312–1337.
Article
3. Holme Ø, Bretthauer M, Fretheim A, Odgaard-Jensen J, Hoff G. Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals. Cochrane Database Syst Rev. 2013; (9):CD009259.
Article
4. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015; 136:E359–E386.
Article
5. Skinner CS, Gupta S, Halm EA, et al. Development of the Parkland-UT Southwestern colonoscopy reporting system (CoRS) for evidence-based colon cancer surveillance recommendations. J Am Med Inform Assoc. 2016; 23:402–406.
Article
6. Lee YJ, Kim ES, Choi JH, et al. Impact of reinforced education by telephone and short message service on the quality of bowel preparation: a randomized controlled study. Endoscopy. 2015; 47:1018–1027.
Article
7. Siegel RL, Miller KD, Fedewa SA, et al. Colorectal cancer statistics, 2017. CA Cancer J Clin. 2017; 67:177–193.
Article
8. Bujanda L, Sarasqueta C, Zubiaurre L, et al. Low adherence to colonoscopy in the screening of first-degree relatives of patients with colorectal cancer. Gut. 2007; 56:1714–1718.
Article
9. Kim DH, Pickhardt PJ, Taylor AJ, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med. 2007; 357:1403–1412.
Article
10. Shafer LA, Walker JR, Waldman C, et al. Factors associated with anxiety about colonoscopy: the preparation, the procedure, and the anticipated findings. Dig Dis Sci. 2018; 63:610–618.
Article
11. Schoofs N, Devière J, Van Gossum A. PillCam colon capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a prospective pilot study. Endoscopy. 2006; 38:971–977.
Article
12. Eliakim R, Yassin K, Niv Y, et al. Prospective multicenter performance evaluation of the second-generation colon capsule compared with colonoscopy. Endoscopy. 2009; 41:1026–1031.
Article
13. Spada C, Hassan C, Galmiche JP, et al. Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2012; 44:527–536.
Article
14. Groth S, Krause H, Behrendt R, et al. Capsule colonoscopy increases uptake of colorectal cancer screening. BMC Gastroenterol. 2012; 12:80.
Article
15. Leighton JA, Rex DK. A grading scale to evaluate colon cleansing for the PillCam COLON capsule: a reliability study. Endoscopy. 2011; 43:123–127.
Article
16. Van Gossum A, Munoz-Navas M, Fernandez-Urien I, et al. Capsule endoscopy versus colonoscopy for the detection of polyps and cancer. N Engl J Med. 2009; 361:264–270.
Article
17. Rex DK, Adler SN, Aisenberg J, et al. Accuracy of capsule colonoscopy in detecting colorectal polyps in a screening population. Gastroenterology. 2015; 148:948–957. e2.
Article
18. Buijs MM, Kroijer R, Kobaek-Larsen M, et al. Intra and inter-observer agreement on polyp detection in colon capsule endoscopy evaluations. United European Gastroenterol J. 2018; 6:1563–1568.
Article
19. Triantafyllou K, Viazis N, Tsibouris P, et al. Colon capsule endoscopy is feasible to perform after incomplete colonoscopy and guides further workup in clinical practice. Gastrointest Endosc. 2014; 79:307–316.
Article
20. Alarcón-Fernández O, Ramos L, Adrián-de-Ganzo Z, et al. Effects of colon capsule endoscopy on medical decision making in patients with incomplete colonoscopies. Clin Gastroenterol Hepatol. 2013; 11:534–540. e1.
21. Buijs MM, Ramezani MH, Herp J, et al. Assessment of bowel cleansing quality in colon capsule endoscopy using machine learning: a pilot study. Endosc Int Open. 2018; 6:E1044–E1050.
Article
22. Spada C, Hassan C, Barbaro B, et al. Colon capsule versus CT colonography in patients with incomplete colonoscopy: a prospective, comparative trial. Gut. 2015; 64:272–281.
Article
23. Rondonotti E, Borghi C, Mandelli G, et al. Accuracy of capsule colonoscopy and computed tomographic colonography in individuals with positive results from the fecal occult blood test. Clin Gastroenterol Hepatol. 2014; 12:1303–1310.
Article
24. Pioche M, Ganne C, Gincul R, et al. Colon capsule versus computed tomography colonography for colorectal cancer screening in patients with positive fecal occult blood test who refuse colonoscopy: a randomized trial. Endoscopy. 2018; 50:761–769.
Article
25. Farnbacher MJ, Krause HH, Hagel AF, Raithel M, Neurath MF, Schneider T. QuickView video preview software of colon capsule endoscopy: reliability in presenting colorectal polyps as compared to normal mode reading. Scand J Gastroenterol. 2014; 49:339–346.
Article
26. Kobaek-Larsen M, Kroijer R, Dyrvig AK, et al. Back-to-back colon capsule endoscopy and optical colonoscopy in colorectal cancer screening individuals. Colorectal Dis. 2018; 20:479–485.
Article
27. Hussey M, Holleran G, Stack R, Moran N, Tersaruolo C, McNamara D. Same-day colon capsule endoscopy is a viable means to assess unexplored colonic segments after incomplete colonoscopy in selected patients. United European Gastroenterol J. 2018; 6:1556–1562.
Article
28. Adrián-de-Ganzo Z, Alarcón-Fernández O, Ramos L, et al. Uptake of colon capsule endoscopy vs colonoscopy for screening relatives of patients with colorectal cancer. Clin Gastroenterol Hepatol. 2015; 13:2293–2301. e1.
Article
29. Parodi A, Vanbiervliet G, Hassan C, et al. Colon capsule endoscopy to screen for colorectal neoplasia in those with family histories of colorectal cancer. Gastrointest Endosc. 2018; 87:695–704.
30. de Leusse A, Saurin JC. L’Observatoire national de l’endoscopie colique par capsule (ONECC). Présentation et bilan à deux ans. Acta Endoscopica. 2014; 44:258–261.
Article
31. Christophe Saurin J, Ponchon T, Gay G, Vahedi K, Christophe Letard J, Benamouzig R. French muticentric experience of colon capsule endoscopy in real practice: primary results of the colon capsule endoscopy observatory “ONECC”. Gastrointest Endosc. 2013; 77(5 Suppl):AB496–AB497.
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