Second-generation colon capsule endoscopy is feasible in the out-of-clinic setting

Abstract

No colorectal imaging test may be performed on an out-of-clinic basis. This represents a major drawback compared with fecal tests. Because colon capsule endoscopy (CCE) automatically detects small bowel mucosa, it has the potential to become the first colorectal imaging test to be performed out-of-clinic. This study aimed to evaluate the feasibility and efficiency of CCE when offered as an out-of-clinic procedure. Patients with known or suspected colonic diseases who had up to 40min of travel time from clinic to home were offered CCE as an out-of-clinic procedure. These patients were provided with four numbered vials (1 with metoclopramide, 2 with sodium phosphate, 1 with bisacodyl) and detailed instructions on how to interact with data-recorder automatic signaling. Patient compliance with data-recorder instructions, CCE excretion, and detection rates were prospectively assessed. The study enrolled 41 patients (29 men) with a mean age of 57years. According to data recorder DR3-registered alerts, 14 patients (34%) required a single booster only, 27 patients (66%) required two boosters, and 13 patients (32%) required a suppository. Comparison of the DR3 alerts with the returned vials showed that patient compliance to DR3 alerts was 100%. During the procedure, 16 patients (39%) called the physician/clinic from home. In 85% of the cases, the CCE was excreted within the battery operating time. Lesions size 6mm or larger were detected in 10 (24%) of the 41 patients. As an out-of-clinic procedure, CCE is feasible and easily performed. A home-based procedure may be associated with better acceptability and potentially with increased adherence to Colorectal cancer screening.