The optimal use of colon capsule endoscopes in clinical practice.

Colon capsule endoscopy (CCE) has been available for nearly two decades but has grappled with being an equal diagnostic alternative to optical colonoscopy (OC). Due to the COVID-19 pandemic, CCE has gained more foothold in clinical practice. In this cutting-edge review, we aim to present the existing knowledge on the pros and cons of CCE and discuss whether the modality is ready for a larger roll-out in clinical settings. We have included clinical trials and reviews with the most significant impact on the current position of CCE in clinical practice and discuss the challenges that persist and how they could be addressed to make CCE a more sustainable imaging modality with an adenoma detection rate equal to OC and a low re-investigation rate by a proper preselection of suitable populations. CCE is embedded with a very low risk of severe complications and can be performed in the patient's home as a pain-free procedure. The diagnostic accuracy is found to be equal to OC. However, a significant drawback is low completion rates eliciting a high re-investigation rate. Furthermore, the bowel preparation before CCE is extensive due to the high demand for clean mucosa. CCE is currently not suitable for large-scale implementation in clinical practice mainly due to high re-investigation rates. By a better preselection before CCE and the implantation of artificial intelligence for picture and video analysis, CCE could be the alternative to OC needed to move away from in-hospital services and relieve long-waiting lists for OC.

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© The Author(s), 2022.

Déclaration de conflit d'intérêts

The authors declared the following potential conflicts of interest with respect to the research, authorship and publication, or both, of this article: Thomas Bjørsum-Meyer has participated in advisory board meetings for Medtronic. Anastasios Koulaouzidis is consultant for Jinshan. He is director of iCERV Ltd. and cofounder of AJM Medicaps Ltd. He has received a GivenImaging Ltd-ESGE grant and material support for clinical research from SynMed/Intromedic. In the past 10 years, he has received honoraria and lecture fees from Jinshan, Dr FalkPharma UK and Ferring. He has also received educational travel support from Aquilant, Jinshan, Dr FalkPharma, Almirall and Ferring, and has participated in advisory board meetings for Tillots, Ankon and Dr FalkPharmaUK.