PillCam colon capsule endoscopy: a prospective, randomized trial comparing two regimens of preparation.
OBJECTIVE
Aim of this study is to assess the feasibility of substituting sodium phosphate (NaP) with polyethylene glycol (PEG)-boosters in the protocol preparation for PillCam Colon Capsule Endoscopy (CCE).


BACKGROUND
CCE represents a new diagnostic, endoscopic technology for colonic exploration. Bowel preparation for CCE is necessary not only to clean the colon, but also to promote capsule propulsion. For this reason, NaP boosters have been added to a 4 L PEG-preparation. NaP has been recently related with major side-effects.


METHODS
Forty patients were prospectively randomized to Standard (n=20) or Modified (n=20) regimen. Standard regimen included clear liquid diet, 4 L of PEG, and 1 or 2 NaP boosters. In the Modified regimen, NaP boosters were substituted by 1 or 2 PEG boosters; 4 senna tablets and a low-residue diet were also included. Patients underwent CCE and conventional colonoscopy, carried out on the same day. CCE excretion rate, colon transit time, colon cleansing, and accuracy were evaluated.


RESULTS
Hundred percent and 75% of CCE were excreted with the Standard and Modified regimen, respectively (P=0.02). Mean±SE colonic transit time of capsule was 2.17±1.43 hours in the Standard group, and 5.32±2.53 hours in the Modified group (P<0.001). Adequate preparation was achieved in 42.5% of the cases, without statistically significant difference between the 2 groups (35% vs. 53%; P=NS). CCE sensitivity and specificity for ≥6 mm polyps were 63% and 87%, without difference between the 2 groups.


CONCLUSIONS
The exclusion of NaP booster from CCE preparation resulted into a clinically meaningful reduction of the capsule excretion rate that was only partially compensated by the PEG booster.
Spada
Cristiano
C
Digestive Endoscopy Unit, Catholic University, Rome, Italy. cristianospada@gmail.com
Riccioni
Maria Elena
ME
Hassan
Cesare
C
Petruzziello
Lucio
L
Cesaro
Paola
P
Costamagna
Guido
G
D000328:Adult; D000368:Aged; D053705:Capsule Endoscopes; D053704:Capsule Endoscopy / Q000379:methods*; D003106:Colon; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy; D005260:Female; D005762:Gastroenterology / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010710:Phosphates; D011092:Polyethylene Glycols; D011300:Preoperative Care; D011446:Prospective Studies; D007507:Therapeutic Irrigation / Q000379:methods*; D016896:Treatment Outcome
D010710:Phosphates; D011092:Polyethylene Glycols; C018279:sodium phosphate