Endoscopic capsule placement improves the completion rate of small-bowel capsule endoscopy and increases diagnostic yield

Background

The methods for increasing the rate of complete small-bowel examinations by capsule endoscopy (CE) demonstrate conflicting results, and it is unknown whether improving the completion rate of CE transit is correlated with improvement in diagnostic yield.

Objective

The aim of this study was to determine whether a higher rate of complete small-bowel examinations results in a higher diagnostic yield of CE.

Design

Case-control comparison.

Setting

Tertiary care university hospital.

Patients

A total of 273 patients underwent conventional CE (group A), and 261 patients underwent real-time CE (group B). Furthermore, the patients in groups A and B were divided into 2 subgroups by pyloric transit time (A1, A2 and B1, B2, respectively).

Interventions

After swallowing the capsule, each patient was monitored with a real-time viewer in group B, and the patients underwent endoscopic placement if the capsule was delayed in the esophagus or stomach.

Main Outcome Measurements

Pyloric transit time, small-bowel transit time, the rate of complete small-bowel examinations, and the diagnostic yield.

Results

The rate of complete small-bowel examinations was significantly higher in group B than in group A (87.4% vs 78.0%, respectively; P = .004). The diagnostic yield was significantly higher in group B2 than in group A2 (60.0% vs 41.7%, respectively; P = .019).

Limitations

Nonrandomized study.

Conclusions

Endoscopic placement improves the rate of complete small-bowel examinations, resulting in a higher diagnostic yield of CE.

Abbreviations: CE, capsule endoscopy, PEG, polyethylene glycol solution, PTT, pyloric transit time, RART, Rapid Access Real-Time, SBTT, small-bowel transit time