Abstract
BackgroundA new capsule endoscopy (CE) system featuring two advanced optics for 344°-viewing and a prolonged operative time has been recently developed for Crohn’s disease (CD) patients. Hence, we evaluated, for the first time, the performance of this novel CE and the add-on value of the 344°-viewing in a multi-center real-life setting.MethodsConsecutive patients with suspected or established CD received the PillCam™ Crohn’s System as supplementary diagnostic work-up focused on the small-bowel between June 2017 and June 2018. Technical and clinical data, including the panenteric CE diagnostic yield, the Lewis score and the impact of small-bowel findings on clinical management during a 6-months follow-up (new diagnosis, staging or treatment upgrade) were collected, thereby evaluating the added value of the 344° panoramic-view (lesions detected by camera A and B) over the standard 172°-view (lesions detected by one camera only).ResultsAmong 41 patients (aged 43 ± 20 years), 73% underwent CE for suspected CD and 27% for established CD. The rate of complete enteroscopy was 90%. No technical failure or retention occurred. Compared to the standard 172° view, the panoramic 344°-view revealed a greater number of patients with a relevant lesion (56.1% vs. 39.0%; P = 0.023), resulting in higher Lewis score (222,8 vs. 185.7; P = 0.031), and improved clinical management (48.8% vs. 31.7%, P = 0.023).ConclusionsThe panoramic 344°-view increases small-bowel CE accuracy, thereby improving the clinical management of CD patients with mild small-bowel active disease. This system should be regarded as a new standard for both small-bowel diagnosis and monitoring in inflammatory bowel diseases.
Highlights
A new capsule endoscopy (CE) system featuring two advanced optics for 344°-viewing and a prolonged operative time has been recently developed for Crohn’s disease (CD) patients
A colonic capsule with an extended battery life and cameras on both sides has been adapted for use in inflammatory bowel diseases (IBD) as a miniinvasive approach for panenteric endoscopy in postoperative follow-up, children and special situations [9,10,11]
In 2017 a new capsule system designed for CD patients was released (PillCamTM Crohn’s System, PillCamTM Crohn’s system (PCS); Medtronic, Dublin, Ireland) [11, 12]
Summary
A new capsule endoscopy (CE) system featuring two advanced optics for 344°-viewing and a prolonged operative time has been recently developed for Crohn’s disease (CD) patients. Capsule endoscopy (CE) is the most sensitive diagnostic tool for the diagnosis of small-bowel mucosal lesions in Crohn’s disease (CD) patients [1,2,3,4]. The aim of the present multi-center study was: firstly to evaluate for the first time the performances of the novel PillCamTM Crohn’s system (PCS) in a multi-center clinical practice setting; secondly, to determine whether the 344°-panoramic view provided by its novel dual-ended camera can improve the small-bowel detection rates and the assessment of the Lewis score, thereby resulting in a different clinical management of CD patients
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