Small Bowel Capsule Endoscopy, Systematic Review and Pairwise Meta- Analysis: the Key Point is the Timing

Aims The aim of the current study is to evaluate the preparation type and the modality of administration to provide an adequate small bowel cleansing in patients undergoing small bowel capsule endoscopy.

Methods From inception to October 2020, we searched within Scopus, Cochrane database, MEDLINE/PubMed, ISI web of Science. All references from the reviewed articles were searched for any other articles that may have been missed. Full text Randomized Clinical Trials (RCT) comparing small bowel preparation prior to capsule endoscopy, for any indication, were included in the analysis. We compared the types of preparation using as reference the fasting preparation type.

Random effect model was used for pooling the summary effect, the principal covariates evaluated were type of preparation, modality of administration and type of study.

Results Starting from 202 studies initially evaluated, after the screening process, a total of 13 articles comparing different type of small bowel preparation for capsule endoscopy were included in the analysis. Overall, we evaluated 1513 patients in 13 studies and 15 treatment arms. Male were 755 (49,9 %) and mean age 52,6 (C.I. 95 % 49,5-55,7). Fasting VS overall purgative preparations pooled RD was -0.18 (95 %CI -0,27 to -0,09, p:). Sub-grouping on the basis of administration modality (all day before, split and all same day): fasting VS all day before RD -0,16 (95 % C.I. -0,279 to -0,041 p = 0,008); fasting VS split RD -0,14 (95 % C.I. -0,46 to 0,17 p = 0,378) and fasting VS all same day RD -0,30 (95 %C.I. -0,53 to -0,07 p = 0,009), fasting VS after capsule ingestion RD -0,41 (95 %C.I. -0,62 to -0,20 p = 0.000).

Modality of administration	RD	95 % C.I.	p
fasting VS all day before	-0,16	-0,279 to -0,041	p = 0,008
fasting VS split	-0,14	-0,46 to 0,17	p = 0,378
fasting VS all same day	-0,30	-0,53 to -0,07	p = 0,009
fasting VS after capsule ingestion	-0,41	-0,62 to -0,20	p = 0.000

Conclusions The administration of purgative solutions prior to small bowel capsule endoscopy ameliorated the small bowel cleansing. However, the most relevant gain was obtained when the preparation was assumed all the same day or, better, after the ingestion of capsule.

Citation: Marmo C, Tortora A, Costamagna G et al. OP9 SMALL BOWEL CAPSULE ENDOSCOPY, SYSTEMATIC REVIEW AND PAIRWISE META- ANALYSIS: THE KEY POINT IS THE TIMING. Endoscopy 2021; 53: S8.

Publication History

Article published online:
19 March 2021