Lazaros-Dimitrios Lazaridis1, Georgios Tziatzios1, Ervin Toth2, Hanneke Beaumont3, Xavier Dray4, Rami Eliakim5, Pierre Ellul6, Ignacio Fernandez-Urien7, Martin Keuchel8, Simon Panter9, Emanuele Rondonotti10, Bruno Rosa11, Cristiano Spada12, Rodrigo Jover13, Pradeep Bhandari14, Konstantinos Triantafyllou1, Anastasios Koulaouzidis15. 1. Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece. 2. Department of Gastroenterology, Skåne University Hospital, Malmö, Lund University, Sweden. 3. Department of Gastroenterology, Amsterdam University Medical Center, location VUMC, Amsterdam, The Netherlands. 4. Sorbonne University, Center for Digestive Endoscopy, Hôpital Saint Antoine, APHP, Paris, France. 5. Sheba Medical Center, Department of Gastroenterology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 6. Division of Gastroenterology, Mater Dei Hospital, Malta. 7. Complejo Hospitalario de Navarra, Pamplona, Spain. 8. Clinic for Internal Medicine, Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany. 9. Department of Gastroenterology, South Tyneside District Hospital, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK. 10. Gastroenterology Unit, Valduce Hospital, Como, Italy. 11. Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal. 12. Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy. 13. Servicio de Medicina Digestiva. Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria ISABIAL, Alicante, Spain. 14. Department of Gastroenterology, Queen Alexandra Hospital Portsmouth, Portsmouth, UK. 15. Pomeranian Medical University, Department of Social Medicine and Public Health, Faculty of Health Science, Szczecin, Poland.
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. European Society of Gastrointestinal Endoscopy. All rights reserved.
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. European Society of Gastrointestinal Endoscopy. All rights reserved.
Authors: João Correia; Ana Ponte; Catarina Gomes; Edgar Afecto; Maria Manuela Estevinho; Adélia Rodrigues; Rolando Pinho; João Carvalho Journal: Turk J Gastroenterol Date: 2022-07 Impact factor: 1.555