APPLICABILITY OF COLON CAPSULE ENDOSCOPY AS PAN-ENDOSCOPY: FROM BOWEL PREPARATION, TRANSIT TIMES AND COMPLETION RATE TO RATING TIMES AND PATIENT ACCEPTANCE

Aims Despite its noninvasive character and its potential to explore the entire gastrointestinal tract, implementation of colon capsule endoscopy (CCE) as pan-endoscopy has not yet been achieved. The applicability of CCE as pan-endoscopy is highly dependent on several quality parameters. The aim of this study was to evaluate these parameters to determine which factors need optimization.

Methods Participants received CCE with corresponding bowel preparation (5mg bisacodyl, 2L PEG and 2L water split-dose) and booster regimen (10mg metoclopramide and 0,5L Eziclen - half directly after and half three hours after small bowel recognition). Different quality parameters were assessed. Patient acceptance was measured by questionnaires.

Results A total of 462 people ingested the colon capsule. Bisacodyl was taken in 99,5%, complete PEG intake was achieved in 98,5% and complete Eziclen intake was achieved in 96,9% of the participants. Due to 11 technical failures (signal interference), 451 procedures were analyzed. The overall colon cleansing score was adequate in 76.6% and the bubbles effect scale was insignificant in 74.7%. The Z-line was objectified in 44.8%. The proportion of visualized stomach mucosa was good (>90%) in 69.6%. The small bowel cleansing was adequate in 99,1%. Median transit times were 55 minutes for the stomach, 47 minutes for the small bowel and 392 minutes for the colon. The capsule reached the descending colon in 95%. Total completion was achieved in 51.2% of the participants. Median staff reading time was 3 minutes for the stomach, 10 minutes for the small bowel and 55 minutes for the colon. Participants graded the procedure with a 7.8 (scale 0-10). There were no procedure-related serious adverse events.

Conclusions CCE is a safe procedure with good patient acceptance. However, technical developments are necessary to achieve complete observation of the gastrointestinal tract and bowel preparation and booster regimen need to be improved.