Multicenter, randomized study to optimize bowel preparation for colon capsule endoscopy.
| Autor: | Kastenberg D; Division of Gastroenterology, Thomas Jefferson University, Philadelphia, PA 19107, United States., Burch WC Jr; Franklin Gastroenterology, PLLC, Franklin, TN 37067, United States., Romeo DP; Dayton Gastroenterology, Inc., Beavercreek, OH 45540, United States., Kashyap PK; Pinnacle Research Group LLC, Anniston, AL 36207, United States., Pound DC; Indianapolis Gastroenterology and Hepatology, Indianapolis, IN 46237, United States., Papageorgiou N; Department of Gastroenterology, American Medical Center, Nicosia 1311, Cyprus., Sainz IF; Department of Gastroenterology, Servicio de Digestivo, Hospital de Navarra, Pamplona 31001, Spain., Sokach CE; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA 19107, United States., Rex DK; Indiana University Hospital, Indianapolis, IN 19107, United States. |
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| Jazyk: | angličtina |
| Zdroj: | World journal of gastroenterology [World J Gastroenterol] 2017 Dec 28; Vol. 23 (48), pp. 8615-8625. |
| DOI: | 10.3748/wjg.v23.i48.8615 |
| Abstrakt: | Aim: To assess the cleansing efficacy and safety of a new Colon capsule endoscopy (CCE) bowel preparation regimen. Methods: This was a multicenter, prospective, randomized, controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system (PillCam ® COLON 2; Medtronic, Yoqneam, Israel) was utilized. Preparation regimens differed in the 1 st and 2 nd boosts with the Study regimen using oral sulfate solution (89 mL) with diatrizoate meglumine and diatrizoate sodium solution ("diatrizoate solution") (boost 1 = 60 mL, boost 2 = 30 mL) and the Control regimen oral sulfate solution (89 mL) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety, polyp detection, colonic transit, CCE completion and capsule excretion ≤ 12 h. Results: Both regimens had similar cleansing efficacy for the whole colon (Adequate: Study = 75.9%, Control = 77.3%; P = 0.88) and individual segments. In the Study group, CCE completion was superior (Study = 90.9%, Control = 76.9%; P = 0.048) and colonic transit was more often < 40 min (Study = 21.8%, Control = 4%; P = 0.0073). More Study regimen subjects experienced adverse events (Study = 19.4%, Control = 3.4%; P = 0.0061), and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen, but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract, from ingestion to excretion, was shorter with the Study regimen while mean colonic transit times were similar for both study groups. Conclusion: A CCE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective, safe, and achieved superior CCE completion. |
| Databáze: | MEDLINE |
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