FTP2.8 The impact of implementation of a colon capsule endoscopy (CCE) service on demand for lower GI endoscopy: A retrospective analysis in a large district general hospital

Abstract

Abstract Aims Demand on endoscopy services have increased due to higher numbers of 2WW referrals and the COVID-19 backlog. Alternatives to endoscopy including CT colonography and colon capsule endoscopy (CCE) have been seen as a way to reduce pressure on endoscopy services. Our centre implemented a CCE service, for patients referred via 2WW colorectal pathway with FIT of 10-100μg Hb/g, or undergoing surveillance. We analysed the impact of this service. Methods We retrospectively analysed patients referred for CCE, from initiation of the service in July 2021 to October 2022. We analysed presenting symptoms, findings at CCE, completion of CCE, and further investigations/treatment required. A total of 198 patients were included. Results 68% (134/198) of CCE were complete, defined as full visualisation of the large bowel through to the anus. 66% (89/134) of these required no further investigations. Of those patients requiring further investigations, 21 underwent flexible sigmoidoscopy, 15 underwent colonoscopy and 6 underwent CT-AP. Only 1 required an operation for malignancy. Of the 64 patients with incomplete CCEs, 63 underwent further investigations, mostly endoscopic (17 colonoscopies, 31 flexible sigmoidoscopies). Conclusions The implementation of a CCE service resulted in 94/198 patients not requiring endoscopic investigations over a 14 month period, highlighting the role for CCE in reducing endoscopy demand. However, there was a high rate of incomplete procedures (32%). With a higher rate of completion, a greater number of endoscopies could be avoided, further reducing the pressure on endoscopy departments.