title: Wireless capsule endoscopy in adolescents with familial adenomatous polyposis.
abstract: OBJECTIVE
  Guidelines for surveillance in patients with familial adenomatous polyposis (FAP) recommend mutation carriers to undergo periodic colorectal examination starting in the early teens. Performing colonoscopy in children may lead to complications. Wireless capsule endoscopy (WCE) has been introduced recently to evaluate both the upper and lower gastrointestinal tract, and seems suitable as a first screening examination for adolescents. The aim of this study was to evaluate the pros and cons of WCE.
  
  
  METHODS
  This was a retrospective review of a single institution database of adolescent patients with FAP identified through the Hereditary Colorectal Tumor Registry between 2007 and 2013. The main outcomes were identification of upper and lower gastrointestinal tract polyps, tolerance of the examination, and number and size of polyps.
  
  
  RESULTS
  Of 46 adolescent patients with FAP, 14 (30.4%) patients carrying adenomatous polyposis coli gene (APC) mutation, 6 male and 8 female, age (median, range) 12 (10-17) years, body mass index 19 (13-24), underwent WCE as first screening examination. The examination was completed in 13 patients (93.3%). Wireless capsule endoscopy identified the duodenal papilla in 4 patients and colonic and rectal polyps in all 13 patients. In 7 patients, fewer than 25 polyps were identified. No complications were recorded related to the use of the video capsule.
  
  
  CONCLUSIONS
  Wireless capsule endoscopy is feasible and well-tolerated as a first screening examination in adolescent patients. It cannot be used as alternative to the colonoscopy, but could improve compliance with colonoscopy, and increase early adherence to a surveillance program.
authors.affiliation: Colorectal Surgery Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Debora
authors.initials: D
authors.lastname: Cavallo
authors.affiliation: Diagnostic and Surgical Endoscopy Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ballardini
authors.affiliation: Pediatric Oncology, Department of Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrari
authors.affiliation: Diagnostic and Surgical Endoscopy Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Delconte
authors.affiliation: Hereditary Digestive Tract Tumors Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Signoroni
authors.affiliation: Hereditary Digestive Tract Tumors Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Sala
authors.affiliation: Pediatric Oncology, Department of Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Chiaravalli
authors.affiliation: Pediatric Oncology, Department of Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Massimino
authors.affiliation: Hereditary Digestive Tract Tumors Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Bertario
authors.affiliation: Colorectal Surgery Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.|Hereditary Digestive Tract Tumors Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Vitellaro
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000175:diagnosis* / Q000235:genetics; D025601:Adenomatous Polyposis Coli Protein / Q000235:genetics*; D000293:Adolescent; D053704:Capsule Endoscopy / Q000295:instrumentation; D002648:Child; D003113:Colonoscopy; D016208:Databases, Factual; D005240:Feasibility Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D009154:Mutation; D011159:Population Surveillance / Q000379:methods*; D012042:Registries; D012189:Retrospective Studies
chemical_list: C555337:APC protein, human; D025601:Adenomatous Polyposis Coli Protein