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Colon capsule endoscopy following incomplete colonoscopy in routine clinical settings

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Abstract

Background

Colon capsule endoscopy (CCE) was introduced in our department on two indications; following incomplete colonoscopy as an alternative to CT colonography, and in patients with a history of incomplete colonoscopy as an alternative to anesthesia-assisted (AA) colonoscopy. We aimed to compare the quality of CCE, defined by completion rate and polyp detection rate (PDR), with that of CT colonography and AA colonoscopy, respectively.

Methods

Patients referred for CCE from May 2020 until November 2021 were consecutively included in this prospective cohort study. Demographics, indication and CCE outcomes were registered from the electronic patient record. Completion rate and PDR in CCE as an alternative to CT colonography were compared with those of a historical cohort undergoing CT colonography following incomplete colonoscopy. Completion rate and PDR in CCE as an alternative to AA colonoscopy were compared with those of a time true parallel cohort undergoing AA colonoscopy.

Results

In 65 patients undergoing CCE, 36 (57%) were referred as an alternative to CT colonography. The completion rate in this group was 44% compared to 96% in CT colonography (p < 0.001). The PDR in complete CCE in this group was 75% in CCE compared to 20% in CT colonography (p < 0.001). The remaining 27 (43%) of the sample were referred for CCE as an alternative to AA colonoscopy. The completion rate in this group was 33% compared to 100% in AA colonoscopy (p < 0.001). The PDR in complete CCE in this group was 78% in CCE compared to 35% in AA colonoscopy (p = 0.013).

Conclusions

The completion rate of CCE following incomplete colonoscopy is inferior to that of CT colonography and AA colonoscopy. The PDR of CCE was high, indicating an acceptable sensitivity in complete investigations, but in our settings the completion rate of CCE on this indication is unacceptably low.

Clinical trial registration: NCT04307901 (ClinicalTrials.gov, March 13, 2020).

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No funding was obtained for the study.

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Authors and Affiliations

  1. Department of Surgery, Odense University Hospital, Svendborg, Denmark

    Anne-Line Volden Havshoi, Ulrik Deding, Sofie Sajan Jensen, Per Vadgaard Andersen, Lasse Kaalby & Issam Al-Najami

  2. Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    Ulrik Deding & Lasse Kaalby

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  1. Anne-Line Volden Havshoi
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  2. Ulrik Deding
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Correspondence to Ulrik Deding.

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Miss Sofie Sajan Jensen, Mr. Lasse Kaalby, Mr. Ulrik Deding, and Drs. Anne-Line Volden Havshoi, Per Vadgaard Andersen and Issam Al-Najami have no conflicts of interest or financial ties to disclose.

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Havshoi, AL.V., Deding, U., Jensen, S.S. et al. Colon capsule endoscopy following incomplete colonoscopy in routine clinical settings. Surg Endosc 37, 2749–2755 (2023). https://doi.org/10.1007/s00464-022-09783-w

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