Small bowel capsule endoscopy in clinical practice: a multicenter 7-year survey.
OBJECTIVE
Data about small bowel capsule endoscopy (SBCE) come from studies involving small and highly selected populations. The study aim was to describe extent of use, indications, results, complications, and practical issues of SBCE in clinical practice in a Northern Italian Region (Lombardia).


METHODS
Twenty-three out of 29 invited centers fulfilled a specific questionnaire.


RESULTS
Between 2001 and 2008, 2921 procedures were performed and both the number of centers performing SBCE (from 5 to 29) and the number of SBCE (from 7.2 to 69.2 per month) increased steadily. The main indications for SBCE were: obscure gastrointestinal bleeding (OGIB) (43.4%), unexplained anemia (23.9%), suspected Crohn's disease (7.8%) and abdominal pain (5.3%). Overall, SBCE was positive in 50% of cases, negative in 36% and undefined in 14%. The highest diagnostic yields were observed in patients with OGIB (62.5%), polypoid syndromes (74.1%), known (54.8%) or suspected (47.3%) inflammatory bowel disease, while the yields were low in patients examined for chronic diarrhea (27.4%) and abdominal pain (14.9%), 61 patients (2.1%) experienced capsule retention. Thirty-two of them eventually excreted the capsule naturally while endoscopic or surgical retrieval was necessary in 29 (1%) (in two because of obstruction).


CONCLUSIONS
Over a period of 7 years the use of SBCE in Lombardia increased steadily confirming, in clinical practice, a high diagnostic yield and an acceptable safety profile.
Rondonotti
Emanuele
E
Università degli Studi di Milano, IRCCS Fondazione Policlinico, Mangiagalli, Regina Elena, Dipartimento di Scienze Mediche, Gastroenterologia 3, Milano, Italy. emanuele.rondonotti@unimi.it
Soncini
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M
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Carlo
C
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Bianchi
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Brunati
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Lazzaroni
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Maino
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Morandi
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E
Pansoni
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Putignano
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Schalling
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Tatarella
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Villa
Federica
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Vitagliano
Pasquale
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Russo
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de Franchis
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D053704:Capsule Endoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D007558:Italy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013997:Time Factors