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DOI: 10.1055/s-0040-1704511
ORAL INGESTION VS ENDOSCOPIC PLACEMENT OF ENDOSCOPIC CAPSULE IN PATIENTS WITH PREVIOUS GASTROINTESTINAL SURGERY (ORENCES): A SPANISH MULTICENTER OBSERVATIONAL STUDY
Publication History
Publication Date:
23 April 2020 (online)
Aims Capsule endoscopy (CE) represents the first-choice technique to investigate the majority of small bowel diseases. Its most common complications are related to incomplete examinations and capsule retention. There is no agreement on how patients with previous gastrointestinal (GI) surgery should receive the capsule.
The primary endpoint was to compare technical success between oral ingestion of the capsule by the patient (OI) and endoscopic placement (EP) of the capsule. Secondary endpoint was to compare diagnostic efficacy and adverse events between the two groups.
Methods A retrospective observational study was conducted in 9 hospitals in Spain. Demographic data, previous surgery, indication for capsule endoscopy, intestinal transit time, diagnosis, technical success (percentage of capsules reaching the caecum), diagnostic yield (percentage of results compatible with indication for the exam) and adverse events were collected.
Results From January 2009 to May 2019 fifty-seven patients were included (39 men, mean age 66 ±15 years). The most common indications for the exam were “overt” (50.9%) and “occult” (35.1%) small bowel bleeding. Previous Billroth II gastrectomy and gastric bypass with Roux-an-Y were present in 52.6% and 17.5% of patients, respectively. The capsule was ingested orally in 34 patients and placed endoscopically in 23 patients. No significant differences were achieved between the OI and EP groups in terms of technical success (82.4% vs 78.3%; p=0.742), diagnostic yield (41.2% vs 52.2%; p=0.432), mean intestinal transit time (301 vs 377 min, p= 0.118) and incomplete procedures (5 vs 6; p=0.742). No capsule retention occurred. Only one severe AE (anastomotic perforation) was observed in the EP group.
Conclusions In our case series, there were no significant differences between the OI and EP in terms of safety, technical success and diagnostic yield. Being less invasive, the OI of the capsule should be the first-choice method in patients with previous GI surgery.
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