Endoscopy 2025; 57(S 02): S143-S144
DOI: 10.1055/s-0045-1805374
Abstracts | ESGE Days 2025
Oral presentation
Late Breaking Abstracts Part 2 05/04/2025, 09:00 – 10:00 Room 118+119

Rethinking Effectiveness: Reinvestigation Rates as an Indicator of Colon Capsule Endoscopy – A Systematic Review and Meta-Analysis

Authors

  • I I Lei

    1   University Hospital Coventry ' Warwickshire, Coventry, United Kingdom

  • A Agache

    2   “Carol Davila” Faculty of Medicine, București, Romania

  • A Roberston

    3   University of Leicester, Leicester, United Kingdom

  • C Thorndal

    4   University Hospital Svendborg Hospital, Svendborg, Denmark

  • U Deding

    5   Odense University Hospital, Odense, Denmark

  • A Koulaouzidiz

    6   Odense University Hospital, Oden, Denmark
Weitere Informationen
Auch verfügbar auf
 

Aims To evaluate the reinvestigation rate following colon capsule endoscopy (CCE) and identify the key factors influencing this outcome.

Methods A systematic review and meta-analysis were conducted following PRISMA guidelines. Electronic databases, including Medline, Embase, and PubMed, were searched for studies reporting reinvestigation rates after CCE, including subsequent endoscopic procedures and radiological imaging. A random-effects model was used for meta-analysis and meta-regression to identify key contributing factors.

Results A total of 2,850 participants from 19 studies were included in the analysis. Compared to key performance indicators (KPIs) for reinvestigation rates in colonoscopy (0.10-0.15) and CT colonography (0.25), the pooled reinvestigation rate for CCE was 0.42 (95% CI: 0.34–0.50), appearing notably high. Meta-regression analysis identified complete transit rates and adequate bowel cleansing quality as significantly inversely associated with reinvestigation rates. Additionally, the CCE2 capsule showed a higher reinvestigation risk compared to CCE1, likely reflecting its improved diagnostic accuracy. While CCE indications were associated with lower reinvestigation rates, subgroup analysis did not demonstrate statistical significance, primarily due to high heterogeneity across studies [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19].

Conclusions This study highlights a significant reinvestigation rate for CCE and identifies key contributing factors, emphasising the importance of appropriate patient selection to reduce reinvestigation needs. Future research should focus on improving completion rates, bowel preparation protocols, and refining CCE indications. Addressing these areas will be essential to enhance cost-effectiveness, reduce environmental impact, and improve patient satisfaction, ultimately paving the way for CCE to become a viable and widely adopted diagnostic service in clinical practice.



Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Pioche M, Ganne C, Gincul R, De Leusse A, Marsot J, Balique J. et al. Colon capsule versus computed tomography colonography for colorectal cancer screening in patients with positive fecal occult blood test who refuse colonoscopy: a randomized trial. Endoscopy 2018; 50 (08): 761-9
    PubMedSuche in Google Scholar
  • 2 Otani I, Oka S, Tanaka S, Iio S, Tsuboi A, Kunihara S. et al. Diagnostic Yield of Colon Capsule Endoscopy in Detection of Superficial Colorectal Lesions. Digestion 2020; 101 (03): 262-9
    CrossrefPubMedSuche in Google Scholar
  • 3 Deding U, Herp J, Havshoei AL, Kobaek-Larsen M, Buijs MM, Nadimi ES. et al. Colon capsule endoscopy versus CT colonography after incomplete colonoscopy. Application of artificial intelligence algorithms to identify complete colonic investigations. United European. Gastroenterol J 2020; 8 (07): 782-9
    PubMedSuche in Google Scholar
  • 4 MacLeod C, Hudson J, Brogan M, Cotton S, Treweek S, MacLennan G. et al. ScotCap – A large observational cohort study. Colorectal Dis 2022; 24 (04): 411-21
    CrossrefPubMedSuche in Google Scholar
  • 5 Triantafyllou K, Tsibouris P, Kalantzis C, Papaxoinis K, Kalli T, Kalantzis N. et al. PillCam Colon capsule endoscopy does not always complement incomplete colonoscopy. Gastrointest Endosc 2009; 69 3 Pt 1: 572-6
    CrossrefPubMedSuche in Google Scholar
  • 6 Herrerias-Gutierrez FA-Aea J.M.. PillCam© Colon Capsule for the study of colonic pathology in clinical practice. Study of agreement with colonoscopy. REV ESP ENFERM D IG 2011; 103 (02): 69-75
    PubMedSuche in Google Scholar
  • 7 Spada C, Hassan C, Barbaro B, Iafrate F, Cesaro P, Petruzziello L. et al. Colon capsule versus CT colonography in patients with incomplete colonoscopy: a prospective, comparative trial. Gut. 2015; 64 (02): 272-81
    CrossrefPubMedSuche in Google Scholar
  • 8 Nogales O, Garcia-Lledo J, Lujan M, Nicolas D, Juanmartinena JF, Gonzalez-Suarez B. et al. Therapeutic impact of colon capsule endoscopy with PillCam COLON 2 after incomplete standard colonoscopy: a Spanish multicenter study. Rev Esp Enferm Dig 2017; 109 (05): 322-7
    PubMedSuche in Google Scholar
  • 9 Ohmiya N, Hotta N, Mitsufuji S, Nakamura M, Omori T, Maeda K. et al. Multicenter feasibility study of bowel preparation with castor oil for colon capsule endoscopy. Dig Endosc 2019; 31 (02): 164-72
    CrossrefPubMedSuche in Google Scholar
  • 10 Kroijer R, Kobaek-Larsen M, Qvist N, Knudsen T, Baatrup G.. Colon capsule endoscopy for colonic surveillance. Colorectal Dis 2019; 21 (05): 532-7
    CrossrefPubMedSuche in Google Scholar
  • 11 Spada C, Hassan C, Ingrosso M, Repici A, Riccioni ME, Pennazio M. et al. A new regimen of bowel preparation for PillCam colon capsule endoscopy: a pilot study. Dig Liver Dis 2011; 43 (04): 300-4
    CrossrefPubMedSuche in Google Scholar
  • 12 Benech N, Vinet O, Gaudin JL, Benamouzig R, Dray X, Ponchon T. et al. Colon capsule endoscopy in clinical practice: lessons from a national 5-year observational prospective cohort. Endosc Int Open 2021; 9 (10): E1542-E8
    PubMedSuche in Google Scholar
  • 13 Groth S, Krause H, Behrendt R, Hill H, Borner M, Basturk M. et al. Capsule colonoscopy increases uptake of colorectal cancer screening. BMC Gastroenterol 2012; 12: 80
    CrossrefPubMedSuche in Google Scholar
  • 14 Alarcon-Fernandez O, Ramos L, Adrian-de-Ganzo Z, Gimeno-Garcia AZ, Nicolas-Perez D, Jimenez A. et al. Effects of colon capsule endoscopy on medical decision making in patients with incomplete colonoscopies. Clin Gastroenterol Hepatol 2013; 11 (05): 534-40 e1
    CrossrefPubMedSuche in Google Scholar
  • 15 Triantafyllou K, Viazis N, Tsibouris P, Zacharakis G, Kalantzis C, Karamanolis DG. et al. Colon capsule endoscopy is feasible to perform after incomplete colonoscopy and guides further workup in clinical practice. Gastrointest Endosc 2014; 79 (02): 307-16
    CrossrefPubMedSuche in Google Scholar
  • 16 Adler SN, Hassan C, Metzger Y, Sompolinsky Y, Spada C.. Second-generation colon capsule endoscopy is feasible in the out-of-clinic setting. Surg Endosc 2014; 28 (02): 570-5
    CrossrefPubMedSuche in Google Scholar
  • 17 Adrian-de-Ganzo Z, Alarcon-Fernandez O, Ramos L, Gimeno-Garcia A, Alonso-Abreu I, Carrillo M. et al. Uptake of Colon Capsule Endoscopy vs Colonoscopy for Screening Relatives of Patients With Colorectal Cancer. Clin Gastroenterol Hepatol 2015; 13 (13): 2293-301 e1
    CrossrefPubMedSuche in Google Scholar
  • 18 Deding U, Bjorsum-Meyer T, Kaalby L, Kobaek-Larsen M, Thygesen MK, Madsen JB. et al. Colon capsule endoscopy in colorectal cancer screening: Interim analyses of randomized controlled trial CareForColon2015. Endosc Int Open 2021; 9 (11): E1712-E9
    PubMedSuche in Google Scholar
  • 19 Havshoi AV, Deding U, Jensen SS, Andersen PV, Kaalby L, Al-Najami I.. Colon capsule endoscopy following incomplete colonoscopy in routine clinical settings. Surg Endosc 2023; 37 (04): 2749-55
    CrossrefPubMedSuche in Google Scholar