Track topics on Twitter Track topics that are important to you
Prevention of colorectal cancer (CRC) is feasible through polypectomy on screening colonoscopy. Patient acceptance remains the main limiting factor for execution. Colon capsule endoscopy (CCE) might be a novel method for large populations.
Aims and methods:
Patients referred for screening means or lower gastrointestinal complaints were included in this single center pilot study. They underwent preparation and then ingested the capsule (PillCam Colon). Standard colonoscopy was performed the next morning. Significance was defined as polyps >5mm in size. Performance of exams was by independent physician with blinding of results.
Study design This was a prospective, single center pilot analysis under screening conditions. Patient enrollment was from November 5, 2007, to May 7, 2008. All patients provided written informed consent. Patients underwent CCE on day 1 and conventional colonoscopy on day 2, the examinations were done by different physicians. Results were blinded until both examinations had been completed and until interobserver evaluation was finished. Patient acceptance was assessed with a questionnaire after completion of both examinations.
This study was approved by the ethics committee. The study was partly funded by the Nycomed Fund of the University Hospital Basel, Switzerland and by Given Imaging Ltd., Yoqneam, Israel).
The authors designed the study, gathered and analyzed the data; the sponsors had no role in design or conduct of the study nor did they review or approve the data.
Patients Men and women above the age of 50 years without symptoms (Indication for screening) or with lower gastrointestinal signs and symptoms and individuals younger than 50 years, minimum 18 years, without symptoms but with a positive family history for colorectal cancer (CRC) (Indication for screening) were considered for this study. Exclusion criteria were CRC in the patient's history, cardiac pacemaker, contraindications for sodium phosphate solution (Colophos®) and risk factors for capsule retention including surgical intestinal anastomosis, Crohn's disease, diverticulitis and radiologically suspected bowel obstruction.
Data collection General characteristic of the patients were assembled, including demographics, family history and recent surgery, as well as bowel habits.
Hypothesis, Aim and End Points Significance was defined as polyps >5mm in size, with the hypothesis that detection rate on CCE corresponds with colonoscopy. The aim was to evaluate a novel method (colon capsule endoscopy) for performance as a screening tool compared to conventional colonoscopy in asymptomatic patients. The proclaimed benefit would be an increase in acceptance of screening for colorectal cancer and a probable better detection rate of adenoma resp. carcinoma.
The primary endpoint was the number of cancerous lesions and polyps detected on CCE compared to conventional colonoscopy. Secondary endpoints were completeness of the exam completeness, patient acceptance and adherence to preparation regimen.
Colon preparation and Propulsion of the Capsule For colon cleansing we applied our department's standard preparation procedure for conventional colonoscopy including diet and Macrogolum (PEG, Cololyt®; Spirig Pharma, Egerkingen, Switzerland) and added an oral motility agent, Phospho Soda (Colophos®; Spirig Pharma, Egerkingen, Switzerland)-boosters and a rectal suppository that promotes defecation, Table 1. Patients started with a low residual diet three days prior to the PillCam® Colon examination. The following day they were required to adhere to a liquid diet and one day before the examination to a clear liquid diet. The evening before the examination they ingested 2 litres of Cololyt® between 18:00 and 19:30 and continued with another 2 litres the next morning between 7:00 and 8:30. At 11:00 they were given 2 tablets of Domperidon (Motilium®; Janssen-Cilag AG, Baar, Switzerland) 10mg a couple of minutes prior to the PillCam® Colon capsule. Propulsion from stomach to small bowel was verified using real time viewing before giving the first Colophos® booster (45 ml). That we later abandoned (for the remaining 49 patients) due to satisfactory propulsion. If the capsule had not been excreted by 17:00 (3 hours after the first dose) a second dose of 30 ml Colophos® was added. If it still had not been excreted by 19:30, a suppository of Bisacodylum 10 mg (Prontolax®; Streuli Pharma, Uznach, Switzerland) was administered. The patient removed electrodes and recorder-belt at the excretion of the capsule or at 22:00, which ever came first, and continued clear liquid diet until the conventional colonoscopy was performed the following day.
Pillcam Colon Capsule The PillCam® Colon Capsule is 11mm x 31mm in size (Figure 1). It is equipped with two cameras acquiring pictures from both ends of the capsule at a rate of 4 frames per second (2 pictures per second and camera). Compared to the PillCam® Small Bowel capsule the optic is optimized and more than double of the area coverage and depth view are provided. The PillCam® Colon Capsule is automatically activated when it is removed from the package. It enters sleeping mode in order to save energy after approximately 10 minutes and starts transmitting again 1 h 45 min later. It has a total operating time of 8 - 10 hours. During the examination the patient wears a sensor array which is attached to the abdominal skin and a data recorder for storage of the information generated by the ingested capsule. After the examination the data are downloaded into the Given Imaging workstation and a video is generated.
Intervention Model: Single Group Assignment, Masking: Single Blind (Investigator), Primary Purpose: Prevention
Colon capsule endoscopy, Conventional Colonoscopy
University Hospital, Basel, Switzerland
Published on BioPortfolio: 2014-08-27T03:18:51-0400
Main objective is to improve colorectal cancer (CRC) screening programme in the Czech Republic and decrease the disease incidence and mortality. The secondary aim is to verify the effectiv...
The dimension of diagnostic procedures and therapy of chronic inflammatory bowel diseases largely depends on the degree of mucosal inflammation. Video colonoscopy is currently the gold sta...
Evaluate accuracy of PCCE-2 in detecting patients with colonic polyps as compared to conventional colonoscopy.
Aims: - To study the feasibility of capsule colonoscopy in patients with Crohn's Disease (CD). - To compare the results of capsule colonoscopy with conventional colonoscopy in ...
PillCam COLON will demonstrate diagnostic yield >80% in detecting significant colonic pathologies when compared to colonoscopy in the target population.
To determine the polyp detection rate and per-patient sensitivity for polyps >9 mm of colon capsule endoscopy (CCE) compared with colonoscopy as well as the diagnostic accuracy of CCE.
Some patients (10 % - 32 %) with a positive guaiac fecal occult blood test (gFOBT) do not undergo the recommended colonoscopy. The aim of this study was to compare video capsule endoscopy (...
We developed the self-propelling capsule endoscope (SPCE), a modified capsule endoscope that can be controlled from outside the patient's body and enables real-time observation. We tested retrograde c...
There are limited colonoscopy-based cohort data concerning the effectiveness of colonoscopy in reducing colorectal cancer deaths. The aim of this study was to clarify whether colonoscopy reduces color...
Background and study aims National societies recommend colorectal cancer (CRC) screening 10 years after a normal ("negative") colonoscopy in low-risk individuals. We studied the impact of a 10-year ...
Tumors or cancer of the COLON or the RECTUM or both. Risk factors for colorectal cancer include chronic ULCERATIVE COLITIS; FAMILIAL POLYPOSIS COLI; exposure to ASBESTOS; and irradiation of the CERVIX UTERI.
A group of autosomal-dominant inherited diseases in which COLON CANCER arises in discrete adenomas. Unlike FAMILIAL POLYPOSIS COLI with hundreds of polyps, hereditary nonpolyposis colorectal neoplasms occur much later, in the fourth and fifth decades. HNPCC has been associated with germline mutations in mismatch repair (MMR) genes. It has been subdivided into Lynch syndrome I or site-specific colonic cancer, and LYNCH SYNDROME II which includes extracolonic cancer.
Non-invasive, endoscopic imaging by use of VIDEO CAPSULE ENDOSCOPES to perform examination of the gastrointestinal tract, especially the small bowel.
Tumor suppressor genes located in the 5q21 region on the long arm of human chromosome 5. The mutation of these genes is associated with the formation of colorectal cancer (MCC stands for mutated in colorectal cancer).
Tumor suppressor genes located in the 18q21-qter region of human chromosome 18. The absence of these genes is associated with the formation of colorectal cancer (DCC stands for deleted in colorectal cancer). The products of these genes show significant homology to neural cell adhesion molecules and other related cell surface glycoproteins.
Bladder Cancer Brain Cancer Breast Cancer Cancer Cervical Cancer Colorectal Head & Neck Cancers Hodgkin Lymphoma Leukemia Lung Cancer Melanoma Myeloma Ovarian Cancer Pancreatic Cancer ...
Alternative Medicine Cleft Palate Complementary & Alternative Medicine Congenital Diseases Dentistry Ear Nose & Throat Food Safety Geriatrics Healthcare Hearing Medical Devices MRSA Muscular Dyst...