Small-bowel capsule endoscopy with panoramic view: results of the first multicenter, observational study (with videos)

• Published in: Gastrointestinal endoscopy 2017-02, Vol.85 (2), p.401-408.e2
• Main Authors: Tontini, Gian Eugenio, MD, PhD, Wiedbrauck, Felix, MD, OA, Cavallaro, Flaminia, MD, PhD, Koulaouzidis, Anastasios, MD, FEBG, FRPCE, FACG, Marino, Roberta, MD, Pastorelli, Luca, MD, PhD, Spina, Luisa, MD, PhD, McAlindon, Mark E., BM, BS, BMed Sci, MRCP, PhD, Leoni, Piera, MD, Vitagliano, Pasquale, MD, Cadoni, Sergio, MD, Rondonotti, Emanuele, MD, PhD, Vecchi, Maurizio, MD
• Format: Article
• Language: English
• Subjects: Aged; Capsule Endoscopy - methods; Crohn Disease - diagnosis; Female; Gastroenterology and Hepatology; Gastrointestinal Hemorrhage - diagnosis; Humans; Intestine, Small; Male; Middle Aged
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2016.07.063

Background and Aims The first small-bowel video-capsule endoscopy (VCE) with 360° panoramic view has been developed recently. This new capsule has wire-free technology, 4 high-frame-rate cameras, and a long-lasting battery life. The aim of the present study was to assess the performance and safety profile of the 360° panoramic-view capsule in a large series of patients from a multicenter clinical practice setting. Methods Consecutive patients undergoing a 360° panoramic-view capsule procedure in 7 European Institutions between January 2011 and November 2015 were included. Both technical (ie, technical failures, completion rate) and clinical (ie, indication, findings, retention rate) data were collected by means of a structured questionnaire. VCE findings were classified according to the likelihood of explaining the reason for referral: P0, low; P1, intermediate; P2, high. Results Of the 172 patients (94 men; median age, 68 years; interquartile range, 53-75), 142 underwent VCE for obscure (32 overt, 110 occult) GI bleeding (OGIB), and 28 for suspected (17) or established (2) Crohn's disease (CD). Overall, 560 findings were detected; 252 were classified as P2. The overall diagnostic yield was 40.1%; 42.2% and 30.0% in patients with OGIB and CD, respectively. The rate of complete enteroscopy was 90.2%. All patients but one, who experienced capsule retention (1/172, 0.6%), excreted and retrieved the capsule. VCE failure occurred in 4 of 172 (2.3%) patients because of technical problems. Conclusions This multicenter study, conducted in the clinical practice setting and based on a large consecutive series of patients, showed that the diagnostic yield and safety profile of the 360° panoramic-view capsule are similar to those of forward-view VCEs.