Meta‐analysis: capsule enteroscopy vs. conventional modalities in diagnosis of small bowel diseases

• Published in: Alimentary pharmacology & therapeutics 2005-10, Vol.22 (7), p.595-604
• Main Authors: MARMO, R., ROTONDANO, G., PISCOPO, R., BIANCO, M. A., CIPOLLETTA, L.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Capsules; Digestive system; Endoscopes; Endoscopy, Gastrointestinal - methods; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Intestinal Diseases - diagnostic imaging; Intestine, Small; Medical sciences; Pharmacology. Drug treatments; Prospective Studies; Radiography; Randomized Controlled Trials as Topic
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2005.02625.x

Summary Background : Prospective trials support the role of capsule enteroscopy as an improvement in diagnosing mucosal lesions in the small bowel. Aim : To determine the diagnostic yield and safety of capsule enteroscopy vs. alternative diagnostic modalities (such as push enteroscopy, small bowel follow‐through or enteroclysis) in patients with small bowel diseases. Methods : A search for prospective studies comparing capsule enteroscopy vs. other diagnostic tests in adults was performed between 1966 and 2005. Selected articles were included in a meta‐analysis. Three analyses were run separately, all included studies and studies having occult gastrointestinal bleeding or Crohn's disease as main outcome. Results : Seventeen studies (526 patients) met inclusion criteria. The rate difference (i.e. the absolute pooled difference in the rate of positive findings) between capsule enteroscopy and alternative modalities for small bowel disease was 41% (95% CI 35.6–45.9); 37% (95% CI 29.6–44.1) for occult gastrointestinal bleeding; and 45% (95% CI 30.9–58.0) for Crohn's disease. Failure to visualize the caecum occurred in 13%, significantly more often in occult bleeders (17%) than in patients with Crohn's disease (8%) (P