Published online Feb 16, 2019. doi: 10.4253/wjge.v11.i2.124
Peer-review started: December 29, 2018
First decision: January 12, 2019
Revised: January 20, 2019
Accepted: January 26, 2019
Article in press: January 26, 2019
Published online: February 16, 2019
Capsule endoscopy (CE) allows for a non-invasive small bowel evaluation for a wide range of gastrointestinal (GI) symptoms and diseases. Capsule technology has been rapidly advancing over recent years, often improving image frequency and quality. The Pillcam® SB3 (SB3) capsule is one such technology that offers an adaptive frame rate advantage over the previous versions of the capsule the Pillcam® SB2 (SB2). Some have proposed that this improvement in capsule technology may lead to increased diagnostic yields; however, real world clinical data is currently lacking.
To evaluate the clinically relevant findings of SB3 and SB2 capsules in a population of United States veterans.
A retrospective analysis of 260 consecutive CE studies was performed including 130 SB3 and 130 SB2 capsule studies. Recorded variables included: age, gender, type of capsule, body mass index, exam completion, inpatient status, opioid use, diabetes, quality of preparation, gastric transit time, small bowel transit time, indication, finding, and if the exam resulted in a change in clinical management. The primary outcome measured was the detection of clinically relevant findings between SB3 and SB2 capsules.
Mean age of the study population was 67.1 ± 10.4 years and 94.2% of patients were male. Of these 28.1% were on opioid users. The most common indications for capsule procedure were occult GI bleeding (74.6%) and overt GI bleeding (14.6%). Rates of incomplete exam were similar between SB3 and SB2 groups (16.9% vs 9.2%, P = 0.066). The overall rate of clinically relevant finding was 48.9% in our study. No significant difference was observed in SB3 vs SB2 capsules for clinically relevant findings (46.2% vs 51.5%, P = 0.385) or change in clinical management (40.8% vs 50.0%, P = 0.135).
Our study found no significant difference in clinically relevant findings between SB3 and SB2 capsules.
Core tip: Capsule endoscopy is a commonly employed diagnostic procedure to evaluate a variety of gastrointestinal symptoms and diseases. The Pillcam® SB3 is a commonly used capsule that has largely replaced previous versions of the capsule. Data evaluating the effect of improvements in capsule technology on diagnostic yields is limited, particularly in the veteran population. This paper compared the diagnostic yields between Pillcam® SB3 and Pillcam® SB2 capsule groups amongst United States veterans and no significant difference in clinically relevant findings or change in clinical management was observed. Further prospective research is warranted to confirm the results of our study.