title: Therapeutic impact of colon capsule endoscopy with PillCam™ COLON 2 after incomplete standard colonoscopy: a Spanish multicenter study.
abstract: BACKGROUND
  Colon capsule endoscopy (CCE) is an alternative approach for the examination of the colon in patients who refuse colonoscopy or after incomplete colonoscopy (IC). We conducted a study to determine the frequency of complete colonoscopy after IC, the diagnostic yield of CCE, the therapeutic impact of lesions found in CCE, the level of colon cleanliness and the safety of the procedure.
  
  
  METHODS
  We performed a prospective, multicenter study involving ten Spanish hospitals. Consecutive outpatients aged ≥ 18 years with previous IC were invited to participate. The latest version of the CCE device, PillCam™ COLON 2 (CCE-2), was administered to all patients according to the protocol.
  
  
  RESULTS
  The study population comprised 96 patients. The most frequent cause of IC was the inability to move past a loop using standard maneuvers (75/96 patients, 78%). Complete visualization of the colon was obtained with CCE-2 in 69 patients (71.9%). Of the 27 patients in whom the CCE-2 did not reach the hemorrhoidal plexus, it passed the colonic segment explored with the previous colonoscopy in 20 cases; therefore, it could be inferred that a combined approach (CCE-2 plus colonoscopy) enabled complete visualization of the colonic mucosa in 92.7% of patients. CCE-2 revealed new lesions in 58 patients (60.4%). Polyps were the most frequent finding (41 patients; 42.7% of the total number of patients). In 43 of the 58 patients (44.8% of the total number of patients), the new lesions observed led to modification of therapy, which included a new colonoscopy for polyp resection or surgery in patients with colonic neoplasm.
  
  
  CONCLUSIONS
  CCE-2 is a suitable diagnostic procedure that can lead to more frequent diagnosis of significant colonic lesions after IC.
authors.affiliation: Servicio Aparato Digestivo, Hospital General Universitario Gregorio Marañon, España.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Nogales
authors.affiliation: Digestivo, Hospital General Universitario Gregorio Marañón. Madrid, ESPAÑA.
authors.forename: Javier
authors.initials: J
authors.lastname: García-Lledó
authors.affiliation: Digestivo, Hospital General Universitario de Valencia.
authors.forename: Marisol
authors.initials: M
authors.lastname: Luján
authors.affiliation: Digestivo, Hospital Universitario de Canarias.
authors.forename: David
authors.initials: D
authors.lastname: Nicolás
authors.affiliation: Unidad de Endoscopia. Aparato Digestivo, Complejo Hospitalario de Navarra, españa.
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Juanmartiñena
authors.affiliation: Endoscopy Unit. Gastroenterology Department. , Hospital Clinic, Barcelona, España.
authors.forename: Begoña
authors.initials: B
authors.lastname: González-Suárez
authors.affiliation: Digestivo, Hospital Clínico San Carlos, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: Sánchez Ceballos
authors.affiliation: CHU A Coruña.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Couto
authors.affiliation: Digestivo, HGUCR, ESPAÑA.
authors.forename: José
authors.initials: J
authors.lastname: Olmedo
authors.affiliation: Digestivo, Hospital Universitario 12 de Octubre.
authors.forename: Cristina
authors.initials: C
authors.lastname: Garfia
authors.affiliation: Digestivo, Clínica Universidad de Navarra, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Carretero
authors.affiliation: Aparato Digestivo, Complejo Hospitalario de Navarra.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Fernández Urién
authors.affiliation: Aparato Digestivo, Hospital Universitario 12 de Octubre, España.
authors.forename: Sarbelio
authors.initials: S
authors.lastname: Rodríguez
authors.affiliation: Aparato Digestivo, Hospital Clínico San Carlos. Madrid, ESPAÑA.
authors.forename: Matilde
authors.initials: M
authors.lastname: Asteinza
authors.affiliation: Cuidad Real, Hospital General Universitario de Ciudad Real, ESPAÑA.
authors.forename: Pilar
authors.initials: P
authors.lastname: Olivencia
authors.affiliation: Hospital Universitario 12 de Octubre.
authors.forename: Ángeles
authors.initials: Á
authors.lastname: Masedo
authors.affiliation: Aparato Digestivo, Clínica Universidad de Navarra.
authors.forename: Miguel
authors.initials: M
authors.lastname: Muñoz-Navas
authors.affiliation: Digestivo, Hospital General Universitario Gregorio Marañón. Madrid, ESPAÑA.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Merino
authors.affiliation: Aparato Digestivo, Hospital General Universitario Gregorio Marañón. Madrid, ESPAÑA.
authors.forename: Cecilia
authors.initials: C
authors.lastname: González Asanza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000295:instrumentation*; D003106:Colon / Q000000981:diagnostic imaging*; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging*; D003111:Colonic Polyps / Q000000981:diagnostic imaging*; D003113:Colonoscopy; D043963:Diverticulosis, Colonic / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain