Brief Article
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World J Gastrointest Endosc. Nov 16, 2013; 5(11): 559-567
Published online Nov 16, 2013. doi: 10.4253/wjge.v5.i11.559
PillCam Colon 2 capsule in patients unable or unwilling to undergo colonoscopy
Lucian Negreanu, Ruxandra Babiuc, Andreea Bengus, Roxana Sadagurschi
Lucian Negreanu, Ruxandra Babiuc, Andreea Bengus, Roxana Sadagurschi, Internal Medicine 2 Gastroenterology Department, University Hospital, Carol Davila University of Medicine Bucharest, 011465 Bucharest, Romania
Author contributions: All authors participated in the study; Negreanu L designed, wrote the article and made corrections; Sadagurschi R helped with article redaction and corrections.
Supported by ESGE–GIVEN Research Grant 2010
Correspondence to: Lucian Negreanu, MD, PhD, Internal Medicine 2 Gastroenterology Department, University Hospital, Carol Davila University of Medicine Bucharest, 169 splaiul Independentei Street, sector 5, 011465 Bucharest, Romania. negreanu_99@yahoo.com
Telephone: +40-72-2546405 Fax: +40-21-3180505
Received: June 29, 2013
Revised: September 5, 2013
Accepted: October 11, 2013
Published online: November 16, 2013
Abstract

AIM: To assess the feasibility, accuracy and acceptability of PillCam Colon 2 in detection of significant lesions in colorectal cancer risk patients, unable or unwilling to perform colonoscopy.

METHODS: This is a prospective, single center study using the second generation of PillCam Colon capsule. In all patients the readers were instructed to review the entire colon capsule endoscopy (CCE) examination using Rapid 7 software and additionally to note significant extra-colonic findings. Colonic significant findings were described according to European Society of Gastrointestinal Endoscopy guidelines. CCE procedure completion rate, level of bowel preparation and rate of adverse events were assessed.

RESULTS: A total of 70 patients at risk of colorectal cancer were enrolled in the study. In three patients the procedure failed because the capsule was not functioning when entered the colon. PillCam Colon 2 showed positive findings in 23 (34%, 95%CI: 21.6%-44.1%) of the remaining 67 patients. Six patients were diagnosed with tumors: 4 with colon cancers, 1 with gastric cancer and 1 with a small bowel cancer. The capsule findings were confirmed after surgery in all these patients. The capsule excretion rate in twelve hours was 77% with 54 patients having a complete examination. The rectum was not explored during CCE procedure, in 16 patients (23%, 95%CI: 13.7%-34.1%). Every patient accepted CCE as an alternative exploration tool and 65/70 (93%) agreed to have another future control by CCE. No complications were reported during or after CCE examination.

CONCLUSION: PillCam Colon 2 capsule was effective in detecting significant lesions and might be considered an adequate alternative diagnostic tool in patients unable or unwilling to undergo colonoscopy.

Keywords: Colon cancer, Colonoscopy failure, Colonoscopy refuse, Colon capsule, Pillcam Colon 2

Core tip: This is an important article on the second generation colon capsule endoscopy. It shows that it has a high diagnostic yield in an enriched population that have had incomplete colonoscopy or refused colonoscopy. We also diagnosed significant extracolonic lesions. The method had a high acceptability among patients and we did not encounter any complications.