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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Apr 10, 2016; 8(7): 344-348
Published online Apr 10, 2016. doi: 10.4253/wjge.v8.i7.344
What is the impact of capsule endoscopy in the long term period?
Asli Ormeci, Filiz Akyuz, Bulent Baran, Suut Gokturk, Tugrul Ormeci, Binnur Pinarbasi, Ozlem Mutluay Soyer, Sami Evirgen, Umit Akyuz, Cetin Karaca, Kadir Demir, Sabahattin Kaymakoglu, Fatih Besisik
Asli Ormeci, Filiz Akyuz, Bulent Baran, Suut Gokturk, Binnur Pinarbasi, Ozlem Mutluay Soyer, Sami Evirgen, Cetin Karaca, Kadir Demir, Sabahattin Kaymakoglu, Fatih Besisik, Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, 34590 Capa, Istanbul, Turkey
Tugrul Ormeci, Department of Radiology, Medipol University, 34214 Bagcilar, Istanbul, Turkey
Umit Akyuz, Department of Gastroenterology, Yeditepe University, 34752 Kozyatagi, Istanbul, Turkey
Author contributions: Akyuz F evaluated the recorded capsule endoscopy images; Ormeci A and Akyuz F collected the clinical data and wrote the manuscript, with contributions from Gokturk S, Pinarbasi B, Soyer OM, Evirgen S, Akyuz U and was responsible for the design of the study and collected the clinical data; Passage opening was evaluated with computerized tomography from Ormeci T; Akyuz F and Baran B performed the statistical analyses; Karaca C, Demir K, Kaymakoglu S and Besisik F participated in the design and coordination of the study; all authors read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Istanbul University, Istanbul Medical Faculty.
Informed consent statement: All patients provided written consent to undergo capsule endoscopy. All data are anonymized and there were no prospective interventions.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at filizakyuz@hotmail.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Filiz Akyuz, Professor, Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Turgut Ozal Millet St., Fatih, 34590 Capa, Istanbul, Turkey. filizakyuz@hotmail.com
Telephone: +90-212-4142000 Fax: +90-212-6319743
Received: June 19, 2015
Peer-review started: June 20, 2015
First decision: July 27, 2015
Revised: October 12, 2015
Accepted: January 27, 2016
Article in press: January 29, 2016
Published online: April 10, 2016
AIM: To assess the clinical impact of capsule endoscopy (CE) in the long-term follow-up period in patients with obscure gastrointestinal bleeding (OGIB).
METHODS: One hundred and forty-one patients who applied CE for OGIB between 2009 and 2012 were retrospectively analyzed, and this cohort was then questioned prospectively. Demographic data of the patients were determined via the presence of comorbid diseases, use of non-steroidal anti-inflammatory drugs anticoagulant-antiaggregant agents, previous diagnostic tests for bleeding episodes, CE findings, laboratory tests and outcomes.
RESULTS: CE was performed on 141 patients because of OGIB. The capsule was retained in the upper gastrointestinal (GI) system in two of the patients, thus video monitoring was not achieved. There were 139 patients [62% male, median age: 72 years (range: 13-93 years) and a median follow-up duration: 32 mo (range: 6-82 mo)]. The overall diagnostic yield of CE was 84.9%. Rebleeding was determined in 40.3% (56/139) of the patients. The rebleeding rates of patients with positive and negative capsule results at the end of the follow-up were 46.6% (55/118) and 4.8% (1/21), respectively. In the multivariate analysis, usage of NSAIDs, anticoagulant-antiaggregant therapies (OR = 5.8; 95%CI: 1.86-18.27) and vascular ectasia (OR = 6.02; 95%CI: 2.568-14.146) in CE were detected as independent predictors of rebleeding. In the univariate analysis, advanced age, comorbidity, and overt bleeding were detected as predictors of rebleeding.
CONCLUSION: CE is a reliable method in the diagnosis of obscure GI bleeding. Negative CE correlated with a significantly lower rebleeding risk in the long-term follow-up period.
Core tip: This study determines the results of using capsule endoscopy in obscure gastrointestinal bleeding in long-term. Our main aim was to describe the long-term clinical impact of capsule endoscopy during follow-up period. Positive capsule endoscopy results correlated with higher rebleeding rates. Independent predictors of rebleeding were detected to be usage of non-steroidal anti-inflammatory drugs, anticoagulant/antiaggregant therapy and vascular ectasia.
