Año 2018 / Volumen 110 / Número 10
Original
Predictive factors of an incomplete examination and inadequate small-bowel cleanliness during capsule endoscopy

605-611

DOI: 10.17235/reed.2018.4834/2017

Ana Ponte, Rolando Pinho, Adélia Rodrigues, Joana Silva, Jaime Rodrigues, Mafalda Sousa, João Carvalho,

Resumen
Aim: the aim of this study was to determine predictive factors for an incomplete capsule endoscopy and an inadequate small-bowel preparation in capsule endoscopy. Methods: predictive factors for an incomplete capsule endoscopy were evaluated. Therefore, all patients with incomplete examinations performed between June 2009 and February 2016 were retrospectively included and compared with all patients with complete procedures performed between January 2014 and February 2016. Predictive factors of an inadequate small-bowel cleanliness were assessed. Therefore, the subset of patients that underwent capsule endoscopy between January 2014 and February 2016, including incomplete examinations, were evaluated. Small-bowel cleanliness was evaluated according to a quantitative index and a qualitative evaluation scale. Data with regard to patient and capsule endoscopy was analyzed. Results: 31 incomplete and 122 complete capsule endoscopies were included in the analysis of predictive factors for an incomplete capsule endoscopy. The degree of dependency (OR = 4.67; p = 0.028), performance of a capsule endoscopy in hospitalized patients (OR = 4.04; p = 0.006) and prior abdominal surgery (OR = 3.45; p = 0.012) were independent predictive factors of an incomplete procedure. 130 patients were included in the analysis of predictive factors for an inadequate small-bowel cleanliness. The mean quantitative index value was 7.3 (s.d. ± 2.3); 41.6% and 58.5% of capsule endoscopies were classified as poor-fair and good/excellent respectively, according to the qualitative evaluation. Independent predictive factors for an inadequate preparation according to the quantitative index included male gender (Beta = -0.79; p = 0.028), small-bowel transit time (Beta = -0.007; p < 0.0001) and cardiac disease (Beta = -1.29; p = 0.001). Associated factors according to the qualitative evaluation included male gender (OR = 0.406; p = 0.027) and small-bowel transit time (SBTT) (OR = 0.993; p < 0.0001). Conclusion: inpatient status, higher degrees of dependency and abdominal surgery are predictive factors for an incomplete capsule endoscopy; male gender and higher small-bowel transit time are predictive factors for an inadequate cleanliness.
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Bibliografía
1) Pennazio M, Spada C, Eliakim R, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2015;47:352-76.
DOI: 10.1055/s-0034-1391855
2) Ladas SD, Triantafyllou K, Spada C, et al. European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of videocaspule endoscopy to investigate small-bowel, esophageal and colonic diseases. Endoscopy. 2010;42:220-7.
DOI: 10.1055/s-0029-1243968
3) Westerhof J, Weersma RK, Koornstra JJ. Risk factors for incomplete small-bowel capsule endoscopy. Gastrointest Endosc. 2009; 69:74-80
DOI: 10.1016/j.gie.2008.04.034
4) van Tuyl SA, den Ouden H, Stolk MF, et al. Optimal preparation for video capsule endoscopy: a prospective, randomized, single-blind study. Endoscopy. 2007;39:1037-40.
DOI: 10.1055/s-2007-966988
5) Kantianis A, Karagiannis S, Liatsos C, et al. Comparison of two schemes of small bowel preparation for capsule endoscopy with polyethylene glycol: a prospective, randomized single-blind study. Eur J Gastroenterol Hepatol. 2009;21:1140-4.
DOI: 10.1097/MEG.0b013e32832b2107
6) Viazis N, Sgouros S, Papaxoinis K, et al. Bowel preparation increases the diagnostic yield of capsule endoscopy: a prospective, randomized, controlled study. Gastrointest Endosc. 2004;60:534-8.
DOI: 10.1016/S0016-5107(04)01879-6
7) Pinho R, Mascarenhas-Saraiva M, Mão-de-Ferro S, et al. Multicenter survey on the use of device-assisted enteroscopy in Portugal. United European Gastroenterol J. 2016;4:264-74.
DOI: 10.1177/2050640615604775
8) Cotter J, de Castro FD, Magalhães J, et al. Finding the solution for incomplete small bowel capsule endoscopy. World J Gastrointest Endosc. 2013; 5:595-9.
DOI: 10.4253/wjge.v5.i12.595
9) Ribeiro I, Pinho R, Rodrigues A, et al. Obscure gastrointestinal bleeding: Which factors are associated with positive capsule endoscopy findings? Rev Esp Enferm Dig. 2015; 107:334-9. PMID: 26031860
10) Park SC, Keum B, Seo YS, et al. Effect of bowel preparation with polyethylene glycol on quality of capsule endoscopy. Dig Dis Sci. 2011;56:1769-75.
DOI: 10.1007/s10620-010-1500-2
11) Ninomiya K, Yao K, Matsui T, et al. Effectiveness of magnesium citrate as preparation for capsule endoscopy: a randomized, prospective, open-label, inter-group trial. Digestion. 2012;86:27-33.
DOI: 10.1159/000337937
12) Lim YJ, Lee OY, Jeen YT, et al. Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry. Clin Endosc. 2015; 48:399-404.
DOI: 10.5946/ce.2015.48.5.399
13) Wei W, Ge ZZ, Lu H, et al. Purgative bowel cleansing combined with simethicone improves capsule endoscopy imaging. Am J Gastroenterol. 2008;103:77-82.
DOI: 10.1111/j.1572-0241.2007.01633.x
14) Brotz C, Nandi N, Conn M, et al. A validation study of 3 grading systems to evaluate small-bowel cleansing for wireless capsule endoscopy: a quantitative index, a qualitative evaluation, and an overall adequacy assessment. Gastrointest Endosc. 2009;69:262-70, 270.e1.
DOI: 10.1016/j.gie.2008.04.016
15) Goyal J, Goel A, McGwin G, et al. Analysis of a grading system to assess the quality of small-bowel preparation for capsule endoscopy: in search of the Holy Grail. Endosc Int Open. 2014;2:E183-6.
DOI: 10.1055/s-0034-1377521
16) Park SC, Keum B, Hyun JJ, et al. A novel cleansing score system for capsule endoscopy. World J Gastroenterol. 2010 Feb 21;16(7):875-80. PMID: 20143467 PMCID: PMC2825335
17) Rondonotti E, Villa F, Mulder CJ, et al. Small bowel capsule endoscopy in 2007: indications, risks and limitations. World J Gastroenterol. 2007;13:6140-9.
DOI: 10.3748/wjg.13.6140
18) Pons Beltrán V, González Suárez B, et al. Evaluation of different bowel preparations for small bowel capsule endoscopy: a prospective, randomized, controlled study. Dig Dis Sci. 2011;56:2900-5.
DOI: 10.1007/s10620-011-1693-z
19) Spada C, Riccioni ME, Familiari P, et al. Polyethylene glycol plus simethicone in small-bowel preparation for capsule endoscopy. Dig Liver Dis. 2010;42:365-70.
DOI: 10.1016/j.dld.2009.07.017
20) Hooks SB 3rd, Rutland TJ, Di Palma JA. Lubiprostone neither decreases gastric and small-bowel transit time nor improves visualization of small bowel for capsule endoscopy: a double-blind, placebo-controlled study. Gastrointest Endosc. 2009;70:942-6.
DOI: 10.1016/j.gie.2009.04.045
21) Van Weyenberg SJ, De Leest HT, Mulder CJ. Description of a novel grading system to assess the quality of bowel preparation in video capsule endoscopy. Endoscopy. 2011;43:406-11.
DOI: 10.1055/s-0030-1256228
22) Pinho R, Ponte A, Rodrigues A, et al. Long-term rebleeding risk following endoscopic therapy of small-bowel vascular lesions with device-assisted enteroscopy. Eur J Gastronterol Hepatol. 2016;28:479-85.
DOI: 10.1097/MEG.0000000000000552
23) Höög CM, Bark LÅ, Arkani J, et al. Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations. Gastroenterol Res Pract. 2012;2012:518718.
DOI: 10.1155/2012/518718
24) Lee MM, Jacques A, Lam E, et al. Factors associated with incomplete small bowel capsule endoscopy studies. World J Gastroenterol. 2010;16:5329-33.
DOI: 10.3748/wjg.v16.i42.5329
25) Chen HB, Huang Y, Chen SY, et al. Small bowel preparations for capsule endoscopy with manitol and simethicone: a prospective, randomized, clinical trial. J Clin Gastroenterol. 2011;45:337-41.
DOI: 10.1097/MCG.0b013e3181f0f3a3
26) Selby W. Complete small-bowel transit in patients undergoing capsule endoscopy: determining factors and improvement with metoclopramide. Gastrointest Endosc. 2005;61:80-5.
DOI: 10.1016/S0016-5107(04)02462-9
27) Fisher LR, Hasler WL. New vision in video capsule endoscopy: current status and future directions. Nat Rev Gastroenterol Hepatol. 201;9:392-405.
28) Kwack WG, Lim YJ. Current Status and Research into Overcoming Limitations of Capsule Endoscopy. Clin Endosc. 2016;49:8-15.
DOI: 10.5946/ce.2016.49.1.8
29) Yee R, Manoharan S, Hall C, et al. Optimizing bowel preparation for colonoscopy: what are the predictors of an inadequate preparation?. Am J Surg. 2015;209:787-92; discussion 792.
DOI: 10.1016/j.amjsurg.2014.12.018
30) Romero RV, Mahadeva S. Factors influencing quality of bowel preparation for colonoscopy. World J Gastrointest Endosc. 2013;5:39-46.
DOI: 10.4253/wjge.v5.i2.39
31) Rosa BJ, Barbosa M, Magalhães J, et al. Oral purgative and simethicone before small bowel capsule endoscopy. World J Gastrointest Endosc. 2013;5:67-73.
DOI: 10.4253/wjge.v5.i2.67
32) Lapalus MG, Ben Soussan E, Saurin JC, et al. Capsule endoscopy and bowel preparation with oral sodium phosphate: a prospective randomized controlled trial. Gastrointest Endosc. 2008;67:1091-6.
DOI: 10.1016/j.gie.2007.11.053
33) Song HJ, Moon JS, Shim KN. Optimal Bowel Preparation for Video Capsule Endoscopy. Gastroenterol Res Pract. 2016;2016:6802810.
DOI: 10.1155/2016/6802810
34) Song HJ, Moon JS, Do JH, et al. Guidelines for bowel preparation before video capsule endoscopy. Clin Endosc. 2013;46:147-54.
DOI: 10.5946/ce.2013.46.2.147
1) Pennazio M, Spada C, Eliakim R, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2015;47:352-76.
DOI: 10.1055/s-0034-1391855
2) Ladas SD, Triantafyllou K, Spada C, et al. European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of videocaspule endoscopy to investigate small-bowel, esophageal and colonic diseases. Endoscopy. 2010;42:220-7.
DOI: 10.1055/s-0029-1243968
3) Westerhof J, Weersma RK, Koornstra JJ. Risk factors for incomplete small-bowel capsule endoscopy. Gastrointest Endosc. 2009; 69:74-80
DOI: 10.1016/j.gie.2008.04.034
4) van Tuyl SA, den Ouden H, Stolk MF, et al. Optimal preparation for video capsule endoscopy: a prospective, randomized, single-blind study. Endoscopy. 2007;39:1037-40.
DOI: 10.1055/s-2007-966988
5) Kantianis A, Karagiannis S, Liatsos C, et al. Comparison of two schemes of small bowel preparation for capsule endoscopy with polyethylene glycol: a prospective, randomized single-blind study. Eur J Gastroenterol Hepatol. 2009;21:1140-4.
DOI: 10.1097/MEG.0b013e32832b2107
6) Viazis N, Sgouros S, Papaxoinis K, et al. Bowel preparation increases the diagnostic yield of capsule endoscopy: a prospective, randomized, controlled study. Gastrointest Endosc. 2004;60:534-8.
DOI: 10.1016/S0016-5107(04)01879-6
7) Pinho R, Mascarenhas-Saraiva M, Mão-de-Ferro S, et al. Multicenter survey on the use of device-assisted enteroscopy in Portugal. United European Gastroenterol J. 2016;4:264-74.
DOI: 10.1177/2050640615604775
8) Cotter J, de Castro FD, Magalhães J, et al. Finding the solution for incomplete small bowel capsule endoscopy. World J Gastrointest Endosc. 2013; 5:595-9.
DOI: 10.4253/wjge.v5.i12.595
9) Ribeiro I, Pinho R, Rodrigues A, et al. Obscure gastrointestinal bleeding: Which factors are associated with positive capsule endoscopy findings? Rev Esp Enferm Dig. 2015; 107:334-9.
DOI: 10.17235/reed.2015.3900/2015
10) Park SC, Keum B, Seo YS, et al. Effect of bowel preparation with polyethylene glycol on quality of capsule endoscopy. Dig Dis Sci. 2011;56:1769-75.
DOI: 10.1007/s10620-010-1500-2
11) Ninomiya K, Yao K, Matsui T, et al. Effectiveness of magnesium citrate as preparation for capsule endoscopy: a randomized, prospective, open-label, inter-group trial. Digestion. 2012;86:27-33.
DOI: 10.1159/000337937
12) Lim YJ, Lee OY, Jeen YT, et al. Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry. Clin Endosc. 2015; 48:399-404.
DOI: 10.5946/ce.2015.48.5.399
13) Wei W, Ge ZZ, Lu H, et al. Purgative bowel cleansing combined with simethicone improves capsule endoscopy imaging. Am J Gastroenterol. 2008;103:77-82.
DOI: 10.1111/j.1572-0241.2007.01633.x
14) Brotz C, Nandi N, Conn M, et al. A validation study of 3 grading systems to evaluate small-bowel cleansing for wireless capsule endoscopy: a quantitative index, a qualitative evaluation, and an overall adequacy assessment. Gastrointest Endosc. 2009;69:262-70, 270.e1.
DOI: 10.1016/j.gie.2008.04.016
15) Goyal J, Goel A, McGwin G, et al. Analysis of a grading system to assess the quality of small-bowel preparation for capsule endoscopy: in search of the Holy Grail. Endosc Int Open. 2014;2:E183-6.
DOI: 10.1055/s-0034-1377521
16) Park SC, Keum B, Hyun JJ, et al. A novel cleansing score system for capsule endoscopy. World J Gastroenterol. 2010 Feb 21;16(7):875-80.
17) Rondonotti E, Villa F, Mulder CJ, et al. Small bowel capsule endoscopy in 2007: indications, risks and limitations. World J Gastroenterol. 2007;13:6140-9.
DOI: 10.3748/wjg.13.6140
18) Pons Beltrán V, González Suárez B, González Asanza, et al. Evaluation of different bowel preparations for small bowel capsule endoscopy: a prospective, randomized, controlled study. Dig Dis Sci. 2011;56:2900-5.
DOI: 10.1007/s10620-011-1693-z
19) Spada C, Riccioni ME, Familiari P, et al. Polyethylene glycol plus simethicone in small-bowel preparation for capsule endoscopy. Dig Liver Dis. 2010;42:365-70.
DOI: 10.1016/j.dld.2009.07.017
20) Hooks SB 3rd, Rutland TJ, Di Palma JA. Lubiprostone neither decreases gastric and small-bowel transit time nor improves visualization of small bowel for capsule endoscopy: a double-blind, placebo-controlled study. Gastrointest Endosc. 2009;70:942-6.
DOI: 10.1016/j.gie.2009.04.045
21) Van Weyenberg SJ, De Leest HT, Mulder CJ. Description of a novel grading system to assess the quality of bowel preparation in video capsule endoscopy. Endoscopy. 2011;43:406-11.
DOI: 10.1055/s-0030-1256228
22) Pinho R, Ponte A, Rodrigues A, et al. Long-term rebleeding risk following endoscopic therapy of small-bowel vascular lesions with device-assisted enteroscopy. Eur J Gastronterol Hepatol. 2016;28:479-85.
DOI: 10.1097/MEG.0000000000000552
23) Höög CM, Bark LÅ, Arkani J, et al. Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations. Gastroenterol Res Pract. 2012;2012:518718.
DOI: 10.1155/2012/518718
24) Lee MM, Jacques A, Lam E, et al. Factors associated with incomplete small bowel capsule endoscopy studies. World J Gastroenterol. 2010;16:5329-33.
DOI: 10.3748/wjg.v16.i42.5329
25) Chen HB, Huang Y, Chen SY, et al. Small bowel preparations for capsule endoscopy with manitol and simethicone: a prospective, randomized, clinical trial. J Clin Gastroenterol. 2011;45:337-41.
DOI: 10.1097/MCG.0b013e3181f0f3a3
26) Selby W. Complete small-bowel transit in patients undergoing capsule endoscopy: determining factors and improvement with metoclopramide. Gastrointest Endosc. 2005;61:80-5.
DOI: 10.1016/S0016-5107(04)02462-9
27) Fisher LR, Hasler WL. New vision in video capsule endoscopy: current status and future directions. Nat Rev Gastroenterol Hepatol. 201;9:392-405.
28) Kwack WG, Lim YJ. Current Status and Research into Overcoming Limitations of Capsule Endoscopy. Clin Endosc. 2016;49:8-15.
DOI: 10.5946/ce.2016.49.1.8
29) Yee R, Manoharan S, Hall C, et al. Optimizing bowel preparation for colonoscopy: what are the predictors of an inadequate preparation?. Am J Surg. 2015;209:787-92; discussion 792.
DOI: 10.1016/j.amjsurg.2014.12.018
30) Romero RV, Mahadeva S. Factors influencing quality of bowel preparation for colonoscopy. World J Gastrointest Endosc. 2013;5:39-46.
DOI: 10.4253/wjge.v5.i2.39
31) Rosa BJ, Barbosa M, Magalhães J, et al. Oral purgative and simethicone before small bowel capsule endoscopy. World J Gastrointest Endosc. 2013;5:67-73.
DOI: 10.4253/wjge.v5.i2.67
32) Lapalus MG, Ben Soussan E, Saurin JC, et al. Capsule endoscopy and bowel preparation with oral sodium phosphate: a prospective randomized controlled trial. Gastrointest Endosc. 2008;67:1091-6.
DOI: 10.1016/j.gie.2007.11.053
33) Song HJ, Moon JS, Shim KN. Optimal Bowel Preparation for Video Capsule Endoscopy. Gastroenterol Res Pract. 2016;2016:6802810.
DOI: 10.1155/2016/6802810
34) Song HJ, Moon JS, Do JH, et al. Guidelines for bowel preparation before video capsule endoscopy. Clin Endosc. 2013;46:147-54.
DOI: 10.5946/ce.2013.46.2.147
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Imagen en Patología Digestiva

Metástasis de dermatofibrosarcoma diagnosticada mediante cápsula endoscópica

DOI: 10.17235/reed.2018.4900/2017

Carta al Editor

Angiotensin-converting enzyme inhibitors-induced angioedema of the small bowel mimicking postoperative complication

DOI: 10.17235/reed.2017.4734/2016

Carta al Editor

Retención sintomática de cápsula degradable Agile®

DOI: 10.17235/reed.2017.4691/2016

Original

Validation of SPICE, a method to differentiate small bowel submucosal lesions from innocent bulges on capsule endoscopy

DOI: 10.17235/reed.2017.4629/2016

Imagen en Patología Digestiva

Hemorragia digestiva por divertículo de Meckel detectado mediante enteroscopia con cápsula endoscópica

Original

Colonic lesions in patients undergoing small bowel capsule endoscopy: incidence, diagnostic and therapeutic impact

DOI: 10.17235/reed.2017.4604/2016

Revisión

Aspectos diagnósticos y terapéuticos de la afectación del intestino delgado en la hipertensión portal

DOI: 10.17235/reed.2017.4596/2016

Imagen en Patología Digestiva

Hemolinfangioma como causa de hemorragia de origen obscuro evidente. Presentación de un caso

Original

Therapeutic impact of colon capsule endoscopy with PillCam™ COLON 2 after incomplete standard colonoscopy: a Spanish multicenter study

DOI: 10.17235/reed.2017.4369/2016

Original

Validation of the computed assessment of cleansing score with the Mirocam® system

DOI: 10.17235/reed.2016.4366/2016

Carta al Editor

Whipple’s disease under the vision of capsule endoscopy

DOI: 10.17235/reed.2016.4362/2016

Carta al Editor

Asymptomatic bronchial aspiration of capsule endoscope: a significant complication

DOI: 10.17235/reed.2016.4363/2016

Imagen en Patología Digestiva

Signet ring cell carcinoma of the jejunum: an uncommon finding within the reach of capsule endoscopy

Original

Calprotectina y proteína C reactiva se asocian a hallazgos en cápsula endoscópica de pacientes con sospecha de enfermedad de Crohn de intestino delgado

DOI: 10.17235/reed.2016.4318/2016

Imagen en Patología Digestiva

Jejunal metastasis of renal cell carcinoma

Caso Clínico

Pyogenic granuloma in the jejunum successfully removed by single-balloon enteroscopy

DOI: 10.17235/reed.2017.4153/2015

Editorial

Hemorragia digestiva oscura y cápsula “oscura”. ¿Podemos encender alguna luz?

DOI: 10.17235/reed.2015.4124/2015

Original

Predictive factors of small bowel patency in Crohn's disease patients

DOI: 10.17235/reed.2015.3957/2015

Original

Guideline for wireless capsule endoscopy in children and adolescents: A consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition) and the SEPD (Spanish Society for Digestive Diseases)

DOI: 10.17235/reed.2015.3921/2015

Original

What is the long-term outcome of a negative capsule endoscopy in patients with obscure gastrointestinal bleeding?

DOI: 10.17235/reed.2015.3900/2015

Original

Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population

DOI: 10.17235/reed.2015.3820/2015

Caso Clínico

Diagnóstico atípico mediante cápsula endoscópica: enfermedad de Whipple

DOI: 10.17235/reed.2015.3718/2015

Imagen en Patología Digestiva

Jejunal plasmablastic lymphoma presenting as obscure overt gastrointestinal bleeding - diagnosis by wireless capsule endoscopy

Instrucciones para citar
Ponte A, Pinho R, Rodrigues A, Silva J, Rodrigues J, Sousa M, et all. Predictive factors of an incomplete examination and inadequate small-bowel cleanliness during capsule endoscopy. 4834/2017


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Recibido: 08/01/2017

Aceptado: 29/04/2018

Prepublicado: 12/06/2018

Publicado: 01/10/2018

Tiempo de revisión del artículo: 472 días

Tiempo de prepublicación: 520 días

Tiempo de edición del artículo: 631 días


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