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Endoscopy 2021; 53(09): 970-980
DOI: 10.1055/a-1541-2938
Position Statement

Implementation of European Society of Gastrointestinal Endoscopy (ESGE) recommendations for small-bowel capsule endoscopy into clinical practice: Results of an official ESGE survey

Lazaros-Dimitrios Lazaridis‡   *
 1   Hepatogastroenterology Unit, Second Department of Internal Medicine – Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
,
Georgios Tziatzios  ‡   *
 1   Hepatogastroenterology Unit, Second Department of Internal Medicine – Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
,
Ervin Toth 
 2   Department of Gastroenterology, Skåne University Hospital, Malmö, Lund University, Sweden
,
Hanneke Beaumont
 3   Department of Gastroenterology, Amsterdam University Medical Center, location VUMC, Amsterdam, The Netherlands
,
Xavier Dray
 4   Sorbonne University, Center for Digestive Endoscopy, Hôpital Saint Antoine, APHP, Paris, France
,
Rami Eliakim
 5   Sheba Medical Center, Department of Gastroenterology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
,
Pierre Ellul
 6   Division of Gastroenterology, Mater Dei Hospital, Malta
,
Ignacio Fernandez-Urien
 7   Complejo Hospitalario de Navarra, Pamplona, Spain
,
Martin Keuchel
 8   Clinic for Internal Medicine, Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany
,
Simon Panter
 9   Department of Gastroenterology, South Tyneside District Hospital, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK
,
Emanuele Rondonotti
10   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
Bruno Rosa
11   Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
,
Cristiano Spada
12   Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy
,
Rodrigo Jover
13   Servicio de Medicina Digestiva. Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria ISABIAL, Alicante, Spain
,
Pradeep Bhandari
14   Department of Gastroenterology, Queen Alexandra Hospital Portsmouth, Portsmouth, UK
,
Konstantinos Triantafyllou
 1   Hepatogastroenterology Unit, Second Department of Internal Medicine – Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
,
Anastasios Koulaouzidis
15   Pomeranian Medical University, Department of Social Medicine and Public Health, Faculty of Health Science, Szczecin, Poland
,
on behalf of the ESGE Research Committee Small-Bowel Working Group › Author Affiliations
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Abstract

Background We aimed to document international practices in small-bowel capsule endoscopy (SBCE), measuring adherence to European Society of Gastrointestinal Endoscopy (ESGE) technical and clinical recommendations.

Methods Participants reached through the ESGE contact list completed a 52-item web-based survey.

Results 217 responded from 47 countries (176 and 41, respectively, from countries with or without a national society affiliated to ESGE). Of respondents, 45 % had undergone formal SBCE training. Among SBCE procedures, 91 % were performed with an ESGE recommended indication, obscure gastrointestinal bleeding (OGIB), iron-deficiency anemia (IDA), and suspected/established Crohn’s disease being the commonest and with higher rates of positive findings (49.4 %, 38.2 % and 53.5 %, respectively). A watchful waiting strategy after a negative SBCE for OGIB or IDA was preferred by 46.7 % and 70.3 %, respectively. SBCE was a second-line exam for evaluation of extent of new Crohn’s disease for 62.2 % of respondents. Endoscopists adhered to varying extents to ESGE technical recommendations regarding bowel preparation ( > 60 %), use in those with pacemaker holders (62.5 %), patency capsule use (51.2 %), and use of a validated scale for bowel preparation assessment (13.3 %). Of the respondents, 67 % read and interpreted the exams themselves and 84 % classified exams findings as relevant or irrelevant. Two thirds anticipated future increase in SBCE demand. Inability to obtain tissue (78.3 %) and high cost (68.1 %) were regarded as the main limitations, and implementation of artificial intelligence as the top development priority (56.2 %).

Conclusions To some extent, endoscopists follow ESGE guidelines on using SBCE in clinical practice. However, variations in practice have been identified, whose implications require further evaluation.

* Joint first authors


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Publication History

Article published online:
28 July 2021

© 2021. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
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