DOES TECHNOLOGY IMPROVEMENTS IN PILLCAM SB3 CAPSULE INCREASES THE DIAGNOSTIC YIELD IN SMALL BOWEL BLEEDING?

Aims:

Since the emergence of the capsule endoscopy (VCE) in 2000, the technology involved in the VCE had changed in an important way. Pillcam SB3 has optimized optics that delivers exceptional images of the mucosa and an adaptive frame rate technology that allows the system to increase the image capture rate from 2 to 6 frames per second. The intention of this study is to demonstrate that technology improvements of the Pillcam SB3 capsule achieve a higher diagnostic yield in patients with small bowel bleeding.

Methods:

This study included all the patients with small bowel bleeding with Pillcam SB3 capsules employed, compared to the same number of patients with Pillcam SB2 capsules registered in database of the Endoscopy Service of the Specialty Hospital of the CMN Siglo XXI, in Mexico City. Lesions were classified as P2 (ulcers, angiodysplasia and tumors), P1 (red spots and erosions) and normal following Saurin's classification.

Results:

A total of 144 capsule endoscopies were applied in the same number of patients, divided in two groups: SB2 group with 72 patients, (medium age of 58 years old (13 – 90) and 56.9% female), and in SB3 group with 72 patients (medium age was 55 years old (20 – 92) and 59.7% female). The P2+P1 lesions were founded in 54 (75%) capsules in SB2 group and in 57 (79.2%) capsules in SB3 group (p= 0.346). Dividing the findings, P2 lesions were identified in 50 (56.2%) in SB2 group and in 39 (43.8%) capsules in SB3 group (p= 0.086), while P1 lesions were founded in 4 (5.6%) capsules in SB2 group and 18 (25%) capsules in SB3 group (p= 0.002). (Table 1)

Tab. 1:

Characteristics and outcomes of capsule e

Characteristics	SB2	SB3	p
Age (Years)	58 (13 – 90)	55 (20 – 92)	0.666
Female	41 (56.9%)	43 (59.7%)	0.433
Small bowel surgery	2 (2.8%)	1 (1.4%)	0.560
Findings P2 + P1 P2 Ulcers Angiodysplasia Tumors Active Bleeding P1 Erosions Red spots Normal	54 (75%) 50 (56.2%) 26 (36.1%) 11 (15.3%) 7 (9.7%) 6 (8.3%) 4 (5.6%) 1 (1.4%) 3 (4.2%) 18 (25%)	57 (79.2%) 39 (43.8%) 14 (19.4%) 12 (16.7%) 2 (2.8%) 11 (15.3%) 18 (25%) 6 (8.3%) 12 (16.7%) 15 (20.8%)	0.346 0.086 0.002 0.346

Conclusions:

Technology improvements in SB3, allows the identification of more P1 lesions. Our limitation is that this is a single center, retrospective study. Further investigation with more patients is needed for confirming our results.