Colon capsule endoscopy is feasible to perform after incomplete colonoscopy and guides further workup in clinical practice.

BACKGROUND

Colon capsule endoscopy (CCE) could be an option to examine the colon after incomplete colonoscopy.

OBJECTIVE

To investigate the extent that CCE complements incomplete colonoscopy and guides further workup.

DESIGN

Prospective, follow-up study.

SETTING

Three tertiary-care centers.

PATIENTS: Consecutive outpatients after colonoscopy failure; 1-year study period.

INTERVENTION: Patients underwent CCE either immediately after colonoscopy or were rescheduled. Further investigations were guided by the results of CCE. Patients were followed as long as 2 years.

RESULTS

We studied 75 outpatients; 39 had a screening colonoscopy. One third of the patients underwent CCE immediately after colonoscopy. Overall, CCE reached or went beyond the colon segment at which colonoscopy stopped in 68 patients (91%). CCE technically complemented difficult colonoscopy independently of whether same-day CCE was performed (24 [96%]) or was not performed (44 [88%]). CCE detected additional significant findings in 36% of the same-day CCE cases and in 48% of the rescheduled ones. Two patients in the same-day group and 13 in the rescheduled CCE group underwent further colon examination that revealed additional significant findings in 3 of them. Ten percent of the patients reported mild adverse events (AE). If needed, 63 participants (84%) were willing to repeat CCE. Follow-up has not identified symptomatic missed colon cancers.

LIMITATIONS: Selected patient population, first-generation colon capsule, old preparation scheme.

CONCLUSION

CCE performed immediately or at a scheduled date after colonoscopy failure is feasible and safe. CCE after incomplete colonoscopy appears to yield significant findings, guide further workup, and has high patient acceptance.