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©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
New reduced volume preparation regimen in colon capsule endoscopy
Yasuo Kakugawa, Yutaka Saito, Shoichi Saito, Kenji Watanabe, Naoki Ohmiya, Mitsuyuki Murano, Shiro Oka, Tetsuo Arakawa, Hidemi Goto, Kazuhide Higuchi, Shinji Tanaka, Hideki Ishikawa, Hisao Tajiri
Yasuo Kakugawa, Division of Screening Technology and Development, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan
Yasuo Kakugawa, Yutaka Saito, Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
Shoichi Saito, Hisao Tajiri, Department of Endoscopy, Jikei University School of Medicine, Tokyo 105-8461, Japan
Kenji Watanabe, Tetsuo Arakawa, Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8685, Japan
Naoki Ohmiya, Hidemi Goto, Department of Therapeutic Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan
Mitsuyuki Murano, Kazuhide Higuchi, Second Department of Internal Medicine, Osaka Medical College, Osaka 569-8686, Japan
Shiro Oka, Shinji Tanaka, Department of Endoscopy, Hiroshima University Hospital, Hiroshima 734-8551, Japan
Hideki Ishikawa, Department of Molecular-Targeting Cancer Prevention, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan
Author contributions: Kakugawa Y participated in the design of the study, data acquisition and interpretation, performed colon capsule endoscopy, and wrote the first draft of the manuscript; Saito Y participated in the design of the study, and in writing the manuscript; Saito S, Watanabe K, Ohmiya N, Murano M and Oka S performed colon capsule endoscopy and contributed to writing the manuscript; Arakawa T, Goto H, Higuchi K and Tanaka S participated in the design of the study, and in writing the manuscript; Ishikawa H participated in the design of the study, data acquisition, and writing the manuscript; Tajiri H participated in the design of the study, data acquisition and interpretation, and writing the manuscript; all authors have read and approved the submission version of the manuscript.
Supported by Foundation for Promotion of Cancer Research by Ministry of Health, Labor and Welfare in Japan
Correspondence to: Dr. Yasuo Kakugawa, MD, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. yakakuga@ncc.go.jp
Telephone: +81-3-35422511 Fax: +81-3-35423815
Received: June 1, 2011
Revised: August 14, 2011
Accepted: September 28, 2011
Published online: May 7, 2012
AIM: To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.
METHODS: A pilot, multicenter, randomized controlled trial compared our proposed “reduced volume method” (group A) with the “conventional volume method” (group B) preparation regimens. Group A did not drink polyethylene glycol electrolyte lavage solution (PEG-ELS) the day before the capsule procedure, while group B drank 2 L. During the procedure day, groups A and B drank 2 L and 1 L of PEG-ELS, respectively, and swallowed the colon capsule (PillCam COLON® capsule). Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups, and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that time. Capsule videos were reviewed for grading of cleansing level.
RESULTS: Sixty-four subjects were enrolled, with results from 60 analyzed. Groups A and B included 31 and 29 subjects, respectively. Twenty-nine (94%) subjects in group A and 25 (86%) subjects in group B had adequate bowel preparation (ns). Twenty-two (71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16 (55%) of the 29 subjects in group B (ns). Of the remaining 22 subjects whose capsules were not excreted within the battery life, all of the capsules reached the left side colon before they stopped functioning. A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS, due to ingesting the PEG-ELS faster than recommended.
CONCLUSION: Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.
