title: Use of Capsule Small Bowel Transit Time to Determine the Optimal Enteroscopy Approach.
abstract: BACKGROUND
  Capsule small bowel transit time (SBTT) is used to select the most effective enteroscopy approach when targeting capsule endoscopy (CE) findings. Aim of this study was to determine if capsule SBTT can be used to guide the choice of enteroscopy technique for reaching CE abnormalities.
  
  
  METHODS
  Single center, retrospective study involving 60 patients. Data were abstracted from medical records of patients with abnormal CE who proceeded to enteroscopy which included push enteroscopy (PE) single balloon enteroscopy (SBE) and double balloon enteroscopy (DBE).
  
  
  RESULTS
  Ninety five findings were documented on CE with presumed identification of 56 (59%) of these abnormalities by enteroscopy. Majority were angioectasias on CE (42%) and enteroscopy (59%). Optimal cutoff values for selection of enteroscopy procedure were: 0-21% SBTT for PE (80% sensitivity, 74% specificity, 83% PPV); 0 - 36% SBTT for antegrade SBE (93% sensitivity, 40% specificity, 82% PPV); 0 - 57% SBTT for antegrade DBE (75% sensitivity, 80% specificity, 75% PPV); and 74 - 100% SBTT for retrograde DBE (88% sensitivity, 78% specificity, 78% PPV).
  
  
  CONCLUSIONS
  Capsule SBTT may be used to guide the selection of enteroscopy approach. PE, antegrade SBE, antegrade DBE and retrograde DBE are optimal when abnormalities on CE are seen at ≤ 21%, ≤ 36%, ≤ 57% and ≥ 74% SBTT respectively.
authors: Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, USA.
authors: Brandon
authors: B
authors: Chalazan
authors: Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, USA.
authors: Christopher J
authors: CJ
authors: Gostout
authors: Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, USA.
authors: Louis M Wong Kee
authors: LM
authors: Song
authors: Health Sciences Research, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, USA.
authors: Felicity T
authors: FT
authors: Enders
authors: Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, USA.
authors: Elizabeth
authors: E
authors: Rajan
keywords: Capsule endoscopy; Capsule small bowel transit time; Double balloon enteroscopy; Enteroscopy; Push enteroscopy; Single balloon enteroscopy