title: Prospective randomized comparison between axial- and lateral-viewing capsule endoscopy systems in patients with obscure digestive bleeding.
abstract: OBJECTIVE
  Video capsule endoscopy (VCE) is recommended as the first exploration in obscure digestive bleeding. The efficiency of the PillCam SB2 (Given Imaging) has been widely reported. The CapsoCam capsule (Capsovision) has four cameras allowing the exploration of the small bowel through 360° lateral viewing. This system does not include a recording system so the capsule has to be retrieved by the patient after expulsion in order for the film to be downloaded. The aim of this study was to evaluate diagnostic concordance (kappa value) of the PillCam SB2 and CapsoCam capsules in the same patients.
  
  
  METHODS
  This was a prospective comparative study in four French referral endoscopy units. Consecutive patients ingested the two capsules 1 hour apart and in a randomized order.
  
  
  RESULTS
  In the 73 included patients there were 13 technical issues (11 CapsoCam, 2 PillCam SB2). Of the 60 patients with analyzable data, and following expert review of all discordant cases, a concordant positive diagnosis was obtained in 23 (38.3 %) and a negative diagnosis was obtained and 26 patients (43.3 %). Concordance was good, with a kappa value of 0.63 in analyzable patients, and 46.7 % diagnosis with CapsoCam vs. 48.3 % with PillCam SB2. CapsoCam and PillCam SB2 procedures identified 81.8 % (27 /33) and 84.8 % (28 /33) of positive patients, respectively (P = 0.791). In a per lesion analysis, the CapsoCam capsule detected significantly more lesions (108 vs. 85 lesions; P = 0.001). Reading time was longer for CapsoCam procedures (32.0 vs. 26.2 minutes; P = 0.002).
  
  
  CONCLUSIONS
  This study shows comparable efficiency of the CapsoCam and PillCam SB2 capsule systems in terms of diagnostic yield and image quality.
authors.affiliation: Gastroenterology Unit, Hôpital E. Herriot, Hospices civils de Lyon, Lyon, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Pioche
authors.affiliation: Gastroenterology Unit, Centre Hospitalier Universitaire de Nice, Nice, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Vanbiervliet
authors.affiliation: Cabinet libéral de Gastro-entérologie, Nîmes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Jacob
authors.affiliation: Gastroenterology Unit, Hôpital St. Philibert, CHU Lille, Lille, France.
authors.forename: Clothilde
authors.initials: C
authors.lastname: Duburque
authors.affiliation: Gastroenterology Unit, Hôpital E. Herriot, Hospices civils de Lyon, Lyon, France.
authors.forename: Rodica
authors.initials: R
authors.lastname: Gincul
authors.affiliation: Gastroenterology Unit, Hôpital St. Philibert, CHU Lille, Lille, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Filoche
authors.affiliation: Cabinet libéral de Gastro-entérologie, Nîmes, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Daudet
authors.affiliation: Gastroenterology Unit, Centre Hospitalier Universitaire de Nice, Nice, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Filippi
authors.affiliation: Gastroenterology Unit, Hôpital E. Herriot, Hospices civils de Lyon, Lyon, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Saurin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053705:Capsule Endoscopes; D053704:Capsule Endoscopy / Q000295:instrumentation* / Q000592:standards; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging / Q000592:standards; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult