PillCamColon2 after incomplete colonoscopy - A prospective multicenter study

Table 1 Study protocols A and B for colon capsule endoscopy after incomplete optical colonoscopy

Time	Procedure
Evening and morning before colonoscopy	Standard bowel prep for colonoscopy
	Incomplete colonoscopy (OC)
After incomplete colonoscopy	Patient´s choice of protocol A or B for colon capsule endoscopy (CCE)
	Protocol A (CCE next day)	Protocol B (CCE within 30 d)
After incomplete colonoscopy	Patient stays on clear liquids	Patient can eat
2 d before CCE		Low residue diet
Day before CCE	NA	Clear liquids only
Evening before CCE		1 L Moviprep + 1 L water
Morning of CCE	0.75 L Moviprep + water	1 l Moviprep + 1 L water
	Colon capsule ingestion
Small bowel detection	0.75 L Moviprep + water (1st boost)
5 h after ingestion	0.5 L Moviprep + water (2nd boost)1
7 h after ingestion	30 mL NaP + water (´Rescue boost)1
	Bisacodyl supp1
11 h after ingestion	Removal of equipment1

¹If capsule is not excreted earlier. OC: Optical colonoscopy.

Table 2 Demographics, reasons for termination of optical colonoscopy, and results of colon capsule endoscopy for protocol A and B n (%)

	Protocol A (CCE next day)	Protocol B ( CCE within 30 d)	Significance
Demographics
Patients	38 (51.4)	36 (48.6)
Female	20/38 (52.6)	24/36 (66.7)
Age, mean ± SD	68.0 ± 12.8 yr	63.9 ± 13.0 yr
Body mass index	26.0 ± 3.9	26.5 ± 4.9
Reasons for termination of colonoscopy
Looping of colon	23/38 (60.5)	23/36 (63.9)
Angulation of colon	6/38 (15.8)	5/36 (13.9)
Susp. adhesions	5/38 (13.2)	6/36 (16.7)
Risk of perforation	2/38 (5.3)	0	P = 0.710 (NS); χ2 test
Sedation problems	2/38 (5.3)	2/36 (5.6)
Results of CCE
Complete CCE	24/38 (63.3)	24/36 (66.7)	P = 0.560 (NS); χ2 test
Complementation of colonoscopy	34/38 (89.5)	35/36 (97.2)	P = 0.350 (NS); χ2 test
Adequate cleansing	25/36 (69.4)	23/36 (63.9)	P = 0.820 (NS); χ2 test
Patients with significant colon polyps	10/38 (26.3)	11/36 (30.6)	P = 0.500 (NS); χ2 test
Patients with other colon findings	0	Angiectasia (n = 3)	P = 0.045; χ2 test
		Diverticulitis (n = 1)
Patients with small bowel findings	Angiectasia (n = 1)	0	P = 0.174 (NS); χ2 test
	Crohn’s disease (n = 1)
Patients with upper GI findings	Reflux esophagitis (n = 1)	Reflux-esophagitis (n = 1)	P = 0.949 (NS); χ2 test
	Upper GI-bleeding (n = 1)	Susp. Barrett esophagus (n = 1)
	Gastric polyps (n = 1)	Gastric erosions (n = 1)

CCE: Colon capsule endoscopy.

Table 3 Details of the 21/74 patients in whom significant polyps/tumors were detected during colon capsule endoscopy

No.	Significance based on	Size of largest polyp (mm)	Number of polyps	Localization of polyps	Farest point reached in OC	All segments with polyps in CCE reached by colonoscopy
1	Size/number	6	5	Rectum	HF	Yes
2	Size	8	2	Sigma	SF	Yes
3	Size/number	8	3	Sigma	AC	Yes
4	Size/number	8	3	2 × Cecum, 1 × AC	TC	No
5	Size	14	1	AC	HF	No
6	Size	26	1	AC	SF	No
7	Size	6	2	AC	Sigma	No
8	Size/number	10	3	2 × AC, 1 × TC	SF	No
9	Size/number	10	3	2 × LC, 1 × AC	Sigma	No
10	Size	10	1	AC	SF	No
11	Size/number	9	3	2 ×AC, 1 × LC	HF	No
12	Size	6	1	AC	Sigma	No
13	Size	8	2	1 × AC/1 × LC	HF	No
14	Size	7	1	HF	Sigma	No
15	Number	5	4	AC, TC, 2 × sigma	Sigma	No
16	Size/number	12	4	1 × Cecum, 1 × AC, 1 × LC, 1 × rectum	Sigma	No
17	Number	4	3	1 × Cecum, 2 × rectum	TC	No
18	Number	5	5	2 × AC, 1 × TC, 2 × LC	HF	No
20	Size/number	10	7	4 × AC, 3 × LC	TC	No
20	Size	9	2	2 × Cecum	LC	No
21	Size/number	12	3	AC	LC	No

AC: Ascending colon; HF: Hepatic flexure; TC: Transverse colon; SF: Splenic flexure; LC: Left colon; OC: Optical colonoscopy.