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CC BY 4.0 · Journal of Digestive Endoscopy 2023; 14(03): 122-126
DOI: 10.1055/s-0043-1774807
Research Article

Small Bowel Capsule Endoscopy: Benefits of Rereading Rather than Repeating—A Single Blinded Randomized Study

Alamir-Noureddine AlAyoubi
1   Department of Internal Medicine, Saint Georges Hospital University Medical Center/University of Balamand, Beirut, Lebanon
,
Ayman Tabcheh
1   Department of Internal Medicine, Saint Georges Hospital University Medical Center/University of Balamand, Beirut, Lebanon
,
Nourhane Obeid
2   Division of Gastroenterology, Department of Internal Medicine, Saint Georges Hospital University Medical Center/University of Balamand, Beirut, Lebanon
,
Antoine Challita
3   Division of Clinical Medicine, Department of Family Medicine and Geriatrics, Saint Georges Hospital University Medical Center/University of Balamand, Beirut, Lebanon
,
Judy Matta
4   Division of Gastroenterology, Department of Pediatrics, Saint Georges Hospital University Medical Center/University of Balamand, Beirut, Lebanon
,
Said Farhat
2   Division of Gastroenterology, Department of Internal Medicine, Saint Georges Hospital University Medical Center/University of Balamand, Beirut, Lebanon
› Author Affiliations Funding None.
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Abstract

Objectives Small bowel capsule endoscopy (SBCE) technology detects small bowel lesions. Many factors affect its sensitivity. SBCE is also costly, and patients might not be able to repeat the test when results are equivocal. Instead of repeating the test, reading the results by two endoscopists might provide a better or a cheaper option in the right settings. We studied the sensitivity of SBCE when read by two different physicians and checked if, rather than repeating the examination, rereading the results improved its sensitivity. Furthermore, we studied the effect of small bowel transit time (SBTT) on the diagnostic yield.

Materials and Methods A retrospective cohort study on capsule endoscopies was conducted between 2018 and 2019 in a tertiary care center in Lebanon. A total of 42 patients with anemia or obscure gastrointestinal bleed were included for SBCE after a negative evaluation with upper and lower gastrointestinal (GI) endoscopy. Two specialists read the results. The second physician was blinded from the first reader's results. We compared the sensitivity of the two readings. SBTT correlation with the diagnostic yield was calculated.

Results Out of 42 patients, 18 tested positive in the first reading and 31 in the second reading. The diagnostic yield increased from 43 to 74% (p = 0.0043). Among the 33 patients who had a documented SBTT, longer SBTT correlated with a higher diagnostic yield (odds ratio [OR] > 1), but no statistical significance was demonstrated.

Conclusion Within the limitations of this study, we found that rereading capsule endoscopy can be more cost-effective than repeating the test.

Keywords

capsule endoscopy - small bowel transit time - anemia - obscure gastrointestinal bleed

Author Contributions

A-N.A. and A.T. contributed equally to designing the research, collecting and analyzing the data, and writing the manuscript. N.O. assisted in the design of the research, collection and analysis of data, and wrote a part of the article. A.C. contributed to data processing and analysis. J.M. and S.F. were the readers of the CE tests and the pioneers of the initial idea of the project. S.F. was the treating physician and the main investigator.




Publication History

Article published online:
22 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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