Jessie Westerhof1, Rinse K Weersma, Jan J Koornstra. 1. Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Abstract
BACKGROUND: In 20% to 30% of capsule endoscopy (CE) procedures, the capsule does not reach the cecum within recording time, with incomplete imaging of the small bowel, which limits the value of CE. OBJECTIVE: To identify possible risk factors for incomplete small-bowel CE examinations. DESIGN: Data from consecutive CE procedures performed between September 2003 and August 2007 were analyzed. All patients had received the same preparation before the CE procedure, including the administration of a prokinetic agent. SETTING: Single-center retrospective study. PATIENTS: A total of 291 CE studies. MAIN OUTCOME MEASUREMENTS: Data were collected regarding patient demographics and potential risk factors. Cecal incompletion rates were calculated. Risk factors were analyzed by using a binary regression analysis. RESULTS: CE was incomplete in 55 cases (19%). The gastric transit time was significantly longer in patients with incomplete CE procedures than in patients with complete CE procedures (median 45 minutes vs 21 minutes, P= .005). Previous small-bowel surgery, hospitalization, moderate or poor bowel cleansing, and a gastric transit time longer than 45 minutes were identified as independent risk factors for incomplete CE procedures. LIMITATION: A retrospective study design. CONCLUSIONS: The identification of several risk factors for incomplete CE procedures allows for selectively targeting these factors in future procedures to reduce the risk of incomplete CE examinations.
BACKGROUND: In 20% to 30% of capsule endoscopy (CE) procedures, the capsule does not reach the cecum within recording time, with incomplete imaging of the small bowel, which limits the value of CE. OBJECTIVE: To identify possible risk factors for incomplete small-bowel CE examinations. DESIGN: Data from consecutive CE procedures performed between September 2003 and August 2007 were analyzed. All patients had received the same preparation before the CE procedure, including the administration of a prokinetic agent. SETTING: Single-center retrospective study. PATIENTS: A total of 291 CE studies. MAIN OUTCOME MEASUREMENTS: Data were collected regarding patient demographics and potential risk factors. Cecal incompletion rates were calculated. Risk factors were analyzed by using a binary regression analysis. RESULTS: CE was incomplete in 55 cases (19%). The gastric transit time was significantly longer in patients with incomplete CE procedures than in patients with complete CE procedures (median 45 minutes vs 21 minutes, P= .005). Previous small-bowel surgery, hospitalization, moderate or poor bowel cleansing, and a gastric transit time longer than 45 minutes were identified as independent risk factors for incomplete CE procedures. LIMITATION: A retrospective study design. CONCLUSIONS: The identification of several risk factors for incomplete CE procedures allows for selectively targeting these factors in future procedures to reduce the risk of incomplete CE examinations.
Authors: Jessie Westerhof; Jan J Koornstra; Reinier A Hoedemaker; Wim J Sluiter; Jan H Kleibeuker; Rinse K Weersma Journal: World J Gastroenterol Date: 2012-04-07 Impact factor: 5.742