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Capsule Endoscopy Ineffective In Detecting Colonic Lesions

According to a prospective, multicenter study, the capsule endoscopy of the colon which allows visualization of the colonic mucosa in most patients,shows less sensitivity for detecting colonic lesions when compared with the use of optical colonoscopy.

An ingestible capsule, PillCam SB from Given Imaging consists of an endoscope equipped with a video camera at both ends to identify the colon. André Van Gossum, MD, from the department of gastroenterology, hepatopancreatology and gastrointestinal oncology at Erasme University Hospital, Université Libre de Bruxelles in Brussels, Belgium, and team conducted a study to compare capsule endoscopy with optical colonoscopy for the detection of colorectal polyps and cancer.

The researchers performed a cohort study of 328 patients with mean age, 58.6 years who had known or suspected colonic disease for the detection of colorectal polyps or cancer. Patients had to undergo an adapted colon preparation, and colon cleanliness was graded from poor to excellent. The sensitivity and specificity of capsule endoscopy for polyps, advanced adenoma and cancer was computed.

Van Gossum and colleagues reported that the capsule was excreted within 10 hours after ingestion and before the end of the lifetime of the battery in 92.8 percent of the patients. The sensitivity and specificity of capsule endoscopy for detecting polyps 6 mm in size or bigger was found to be 64 percent and 84 percent, respectively, and for detecting advanced adenoma, the sensitivity and specificity were 73 percent and 79 percent, respectively.

Of 19 cancers detected by colonoscopy, 14 were detected by capsule endoscopy which shows the sensitivity of 74 percent.

The authors concluded that colon cleanliness significantly influences the sensitivity of capsule endoscopy. For all lesions, capsule endoscopy in patients with good or excellent colon cleanliness had higher sensitivity than in those with fair or poor colon cleanliness. However, 26 patients (7.9 percent) reported mild-to-moderate adverse events and were mostly related to the colon preparation.