An evaluation of a novel bowel preparation regimen and its effect on the utility of colon capsule endoscopy: a prospective cohort study with historical controls.
Boosters
Bowel preparation
Colon capsule endoscopy
Colorectal cancer
Polyps
Journal
Techniques in coloproctology
ISSN: 1128-045X
Titre abrégé: Tech Coloproctol
Pays: Italy
ID NLM: 9613614
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
01
10
2022
accepted:
07
12
2022
medline:
27
7
2023
pubmed:
20
12
2022
entrez:
19
12
2022
Statut:
ppublish
Résumé
The aim of this study was to evaluate the efficacy of a novel bowel preparation and booster regimen for colon capsule endoscopy (CCE) using macrogol, phospho-soda and gastrografin, compared with a control regimen consisting of polyethylene glycol and sodium picosulfate. This was a prospective cohort study using historical controls. Symptomatic patients undergoing CCE between 11/07/2021 and 21/12/2021 using the novel regimen were included. Symptomatic patients who underwent CCE in the ScotCap evaluation using the control regimen were used as historical controls. We measured the rate of complete test (visualisation of the whole colon and rectum), adequate bowel preparation, successful test (complete and adequate bowel preparation) and need for further test following CCE. The rate of adverse events was also collected. Patients undergoing CCE using the new and control regimen were 200 and 316, respectively. The median age, age range and proportion of female patients in the new and control regimen cohorts was 61 vs 60 years, 16-86 vs 20-83 years, and 60.5% vs 56.6%. The rate of complete test, adequate bowel reparation and successful test for the new and control regimen was 69% vs 72.2%, 86.6% vs 80.7% and 60.5% vs 65.8%. Comparing the new and control regimen, 39.5% vs 37.3% of patients required no test following CCE, 26% vs 32.6% required a colonoscopy, 31.5% vs 21.5% required a flexible sigmoidoscopy and 3% vs 2.9% required a computed tomography colonogram. No adverse events were reported using the new regimen compared to 2 (0.6%) in the control group. The rate of adequate bowel preparation has improved following the introduction of a new regimen. However, further work is needed to increase the complete test rate. A significant proportion of patients continue to avoid colonoscopy following CCE.
Sections du résumé
BACKGROUND
The aim of this study was to evaluate the efficacy of a novel bowel preparation and booster regimen for colon capsule endoscopy (CCE) using macrogol, phospho-soda and gastrografin, compared with a control regimen consisting of polyethylene glycol and sodium picosulfate.
METHODS
This was a prospective cohort study using historical controls. Symptomatic patients undergoing CCE between 11/07/2021 and 21/12/2021 using the novel regimen were included. Symptomatic patients who underwent CCE in the ScotCap evaluation using the control regimen were used as historical controls. We measured the rate of complete test (visualisation of the whole colon and rectum), adequate bowel preparation, successful test (complete and adequate bowel preparation) and need for further test following CCE. The rate of adverse events was also collected.
RESULTS
Patients undergoing CCE using the new and control regimen were 200 and 316, respectively. The median age, age range and proportion of female patients in the new and control regimen cohorts was 61 vs 60 years, 16-86 vs 20-83 years, and 60.5% vs 56.6%. The rate of complete test, adequate bowel reparation and successful test for the new and control regimen was 69% vs 72.2%, 86.6% vs 80.7% and 60.5% vs 65.8%. Comparing the new and control regimen, 39.5% vs 37.3% of patients required no test following CCE, 26% vs 32.6% required a colonoscopy, 31.5% vs 21.5% required a flexible sigmoidoscopy and 3% vs 2.9% required a computed tomography colonogram. No adverse events were reported using the new regimen compared to 2 (0.6%) in the control group.
CONCLUSIONS
The rate of adequate bowel preparation has improved following the introduction of a new regimen. However, further work is needed to increase the complete test rate. A significant proportion of patients continue to avoid colonoscopy following CCE.
Identifiants
pubmed: 36534182
doi: 10.1007/s10151-022-02745-3
pii: 10.1007/s10151-022-02745-3
doi:
Substances chimiques
Polyethylene Glycols
3WJQ0SDW1A
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
665-672Informations de copyright
© 2022. Springer Nature Switzerland AG.
Références
MacLeod C, Monaghan E, Banerjee A et al (2020) Colon capsule endoscopy. Surgeon 18:251–256
doi: 10.1016/j.surge.2020.01.008
pubmed: 32178986
Kjolhede T, Olholm AM, Kaalby L et al (2020) Diagnostic accuracy of capsule endoscopy compared with colonoscopy for polyp detection: systematic review and meta-analyses. Endoscopy 53(07):713–721
pubmed: 32858753
Vuik FER, Nieuwenburg SAV, Moen S et al (2021) Colon capsule endoscopy in colorectal cancer screening: a systematic review. Endoscopy 53:815–824. https://doi.org/10.1055/A-1308-1297
doi: 10.1055/A-1308-1297
pubmed: 33440442
González-Suárez B, Pagés M, Araujo IK et al (2020) Colon capsule endoscopy versus CT colonography in FIT-positive colorectal cancer screening subjects: a prospective randomised trial - the VICOCA study. BMC Med. https://doi.org/10.1186/s12916-020-01717-4
doi: 10.1186/s12916-020-01717-4
pubmed: 32943059
pmcid: 7500543
Cash BD, Fleisher MR, Fern S et al (2021) Multicentre, prospective, randomised study comparing the diagnostic yield of colon capsule endoscopy versus CT colonography in a screening population (the TOPAZ study). Gut 70:2115–2122. https://doi.org/10.1136/GUTJNL-2020-322578
doi: 10.1136/GUTJNL-2020-322578
pubmed: 33443017
Utano K, Katsuki S, Matsuda T et al (2020) Colon capsule endoscopy versus Ct Colonography in patients with large non-polypoid Tumours: a multicentre prospective comparative study (4CN Study). Digestion 101:615–623. https://doi.org/10.1159/000501609
doi: 10.1159/000501609
pubmed: 31574525
Spada C, Hassan C, Galmiche JP et al (2012) Colon capsule endoscopy: European society of gastrointestinal endoscopy (esge) guideline. Endoscopy 44:527–536
doi: 10.1055/s-0031-1291717
pubmed: 22389230
Bjoersum-Meyer T, Skonieczna-Zydecka K, Cortegoso Valdivia P et al (2021) Efficacy of bowel preparation regimens for colon capsule endoscopy: a systematic review and meta-analysis. Endosc Int Open 9:E1658–E1673. https://doi.org/10.1055/A-1529-5814
doi: 10.1055/A-1529-5814
pubmed: 34790528
pmcid: 8589531
Kroijer R, Kobaek-Larsen M, Qvist N et al (2019) Colon capsule endoscopy for colonic surveillance. Colorectal Dis 21:532–537. https://doi.org/10.1111/codi.14557
doi: 10.1111/codi.14557
pubmed: 30637886
Kroijer R, Dyrvig A-K, Kobaek-Larsen M et al (2018) Booster medication to achieve capsule excretion in colon capsule endoscopy: a randomized controlled trial of three regimens. Endosc Int Open 06:E1363–E1368. https://doi.org/10.1055/a-0732-494
doi: 10.1055/a-0732-494
MacLeod C, Hudson J, Brogan M et al (2021) ScotCap - a large observational cohort study. Colorectal Dis. https://doi.org/10.1111/CODI.16029
doi: 10.1111/CODI.16029
Rex DK, Adler SN, Aisenberg J et al (2015) Accuracy of capsule colonoscopy in detecting colorectal polyps in a screening population. Gastroenterology 148:948-957.e2. https://doi.org/10.1053/j.gastro.2015.01.025
doi: 10.1053/j.gastro.2015.01.025
pubmed: 25620668
Leighton JA, Rex DK (2011) A grading scale to evaluate colon cleansing for the PillCam COLON capsule: a reliability study. Endoscopy 43:123–127. https://doi.org/10.1055/S-0030-1255916
doi: 10.1055/S-0030-1255916
pubmed: 21038293
Lai EJ, Calderwood AH, Doros G et al (2009) The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research. Gastrointest Endosc 69:620–625. https://doi.org/10.1016/j.gie.2008.05.057
doi: 10.1016/j.gie.2008.05.057
pubmed: 19136102
pmcid: 2763922
Spada C, Hassan C, Bellini D et al (2021) Imaging alternatives to colonoscopy: CT colonography and colon capsule. European society of gastrointestinal endoscopy (ESGE) and european society of gastrointestinal and abdominal radiology (ESGAR) guideline - update 2020. Eur Radiol 31:2967–2982. https://doi.org/10.1007/S00330-020-07413-4
doi: 10.1007/S00330-020-07413-4
pubmed: 33104846
The Scottish Health Technologies Group (2020). Second-generation colon capsule endoscopy ( CCE-2 ) for the detection of colorectal polyps. August 2020. Available at https://shtg.scot/media/1888/second-generation-colon-capsule-endoscopy-cce-2-for-the-detection-of-colorectal-polyps-shtg-recommendation-01-20-gastro.pdf
Kastenberg D, Burch WC, Romeo DP et al (2017) Multicenter, randomized study to optimize bowel preparation for colon capsule endoscopy. World J Gastroenterol 23:8615. https://doi.org/10.3748/WJG.V23.I48.8615
doi: 10.3748/WJG.V23.I48.8615
pubmed: 29358870
pmcid: 5752722
Deding U, Kaalby L, Baatrup G et al (2022) The effect of prucalopride on the completion rate and polyp detection rate of colon capsule endoscopies. Clin Epidemiol 14:437. https://doi.org/10.2147/CLEP.S353527
doi: 10.2147/CLEP.S353527
pubmed: 35401015
pmcid: 8985819
MacLeod C, Mowat C, Mowat C, Winter J, Todd J, Ray C, Maxwell F, McKinley A, Noble C, Collins P, Wilson L, Cruikshank N, Hendry P, Leggett G, Fletcher J, Weber B, Moug S, Watson AJM (2021) Follow-up of small and diminutive colonic polyps-How to balance the risks in the COVID-19 era. Colorectal Dis 23:3061–3064. https://doi.org/10.1111/CODI.15907
doi: 10.1111/CODI.15907
Deding U, Cortegoso Valdivia P, Koulaouzidis A et al (2021) Patient-reported outcomes and preferences for colon capsule endoscopy and colonoscopy: a systematic review with meta-analysis. Diagnostics 11:1730. https://doi.org/10.3390/diagnostics11091730
doi: 10.3390/diagnostics11091730
pubmed: 34574071
pmcid: 8468090
Takashima K, Komeda Y, Sakurai T et al (2021) Castor oil as booster for colon capsule endoscopy preparation reduction: a prospective pilot study and patient questionnaire. World J Gastrointest Pharmacol Ther 12:79. https://doi.org/10.4292/WJGPT.V12.I4.79
doi: 10.4292/WJGPT.V12.I4.79
pubmed: 34316385
pmcid: 8290927