Endoscopic capsule placement improves the completion rate of small-bowel capsule endoscopy and increases diagnostic yield.

BACKGROUND: The methods for increasing the rate of complete small-bowel examinations by capsule endoscopy (CE) demonstrate conflicting results, and it is unknown whether improving the completion rate of CE transit is correlated with improvement in diagnostic yield. OBJECTIVE: The aim of this study was to determine whether a higher rate of complete small-bowel examinations results in a higher diagnostic yield of CE. DESIGN: Case-control comparison. SETTING: Tertiary care university hospital. PATIENTS: A total of 273 patients underwent conventional CE (group A), and 261 patients underwent real-time CE (group B). Furthermore, the patients in groups A and B were divided into 2 subgroups by pyloric transit time (A1, A2 and B1, B2, respectively). INTERVENTIONS: After swallowing the capsule, each patient was monitored with a real-time viewer in group B, and the patients underwent endoscopic placement if the capsule was delayed in the esophagus or stomach. MAIN OUTCOME MEASUREMENTS: Pyloric transit time, small-bowel transit time, the rate of complete small-bowel examinations, and the diagnostic yield. RESULTS: The rate of complete small-bowel examinations was significantly higher in group B than in group A (87.4% vs 78.0%, respectively; P = .004). The diagnostic yield was significantly higher in group B2 than in group A2 (60.0% vs 41.7%, respectively; P = .019). LIMITATIONS: Nonrandomized study. CONCLUSIONS: Endoscopic placement improves the rate of complete small-bowel examinations, resulting in a higher diagnostic yield of CE.

PillCam colon capsule endoscopy versus conventional colonoscopy for the detection of severity and extent of ulcerative colitis.

OBJECTIVE: To evaluate PillCam colon capsule endoscopy (PCCE) in detecting the severity and extent of active ulcerative colitis (UC), in comparison with conventional endoscopy. METHODS: From July 2009 to June 2012, patients with confirmed UC were enrolled in this prospective single-center study. After they had undergone the PCCE, they received a conventional colonoscopy. The extent of mucosal damage and inflammatory lesions during both procedures was recorded for comparison. In addition, the regimen of bowel preparation, completion rate, colonic cleansing, compliance or adverse events were analyzed. RESULTS: A total of 26 patients was consecutively included, among whom one was withdrawn. The remaining 25 (nine females and 16 males with a mean age of 44.2 years) completed the study. There was significant correlation in the severity (κ = 0.751, P < 0.001) and extent (κ = 0.522, P < 0.001) of UC between the PCCE and conventional colonoscopy. In addition, the excellent to good rate of colonic cleanliness in PCCE was 80%. There were no remarkable adverse events during the study. CONCLUSION: PCCE provides an outstanding performance in the detection of the severity and extent of active UC.