Endoscopy 2019; 51(04): S10
DOI: 10.1055/s-0039-1681198
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: Capsule 1 Club B
Georg Thieme Verlag KG Stuttgart · New York

CAPSULE RETENTION IN CROHN DISEASE: A META-ANALYSIS

SF Pasha
1   Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Arizona, Scottsdale, United States
,
M Pennazio
2   Division of Gastroenterology, San Giovanni AS University Teaching Hospital, Torino, Italy
,
E Rondonotti
3   Gastroenterology Unit, Ospedale Valduce, Como, Italy
,
D Wolf
4   Gastroenterology, Atlanta Gastroenterology Associates, Atlanta, United States
,
MR Buras
5   Division of Health Sciences Research, Mayo Clinic, Arizona, Scottsdale, United States
,
JG Albert
6   Department of Medicine, Johann Wolfgang Goethe University Hospital and Clinics, Frankfurt, Germany
,
SA Cohen
7   Children's Center for Digestive Healthcare, Children's Healthcare of Atlanta, Atlanta, United States
,
J Cotter
8   Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
9   ICVS/3B's Associate Laboratory, University of Minho, Braga, Portugal
10   Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
,
G D'Haens
11   Imelda GI Clinical Research Centre, Bonheiden, Belgium
,
R Eliakim
12   Department of Gastroenterology, Sheba Medical Center, Tel Aviv, Israel
,
DT Rubin
13   Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, United States
,
JA Leighton
1   Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Arizona, Scottsdale, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

To evaluate capsule retention rates in adult and pediatric Crohn disease (CD) and determine if retention risk can be reduced in established CD (ECD) with patency capsule (PC) or dedicated small bowel (SB) cross sectional imaging (MR/CT enterography) using meta-analysis.

Methods:

Publications were identified in MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Web of Science for studies of CD patients undergoing capsule endoscopy (CE) that reported retention. The retention rate and relative risk (RR) of retention in ECD to suspected CD (SCD) was estimated for each study. The pooled estimates for the various capsule retention rates and for RR were also calculated. All hypothesis tests were two-sided with p < 0.05 considered statistically significant.

Results:

Retention rates were 0.03 (95% CI 0.03 – 0.04) in the overall CD cohort, 0.05 (95% CI 0.03 – 0.06) in ECD, and 0.02 (95% CI 0.01 – 0.04) in SCD. The retention rates in adult and pediatric studies were 0.03 (95% CI 0.03 – 0.04) and 0.02 (95% CI 0.01 – 0.04), respectively. Retention risk in adult ECD was 3.50 times higher than SCD (95% CI 2.12 – 5.78). There was no difference in retention risk in pediatric ECD compared with SCD (RR 4.92; 95% CI 0.80 – 30.08). Retention rates in ECD were decreased to 0.02 (95% CI 0.01 – 0.06) after cross-sectional imaging, and 0.03 (95% CI 0.02 – 0.05) after negative PC.

Conclusions:

Our meta-analysis shows lower CE retention rates in both SCD and ECD compared to older literature. The retention rate in adult ECD was significantly higher than adult SCD. In patients with ECD, retention rates were lower after negative PC or cross-sectional imaging. Retention rates in pediatric CD were lower than adult CD, and in contrast to adults, there was no difference in retention rates between pediatric ECD and SCD.