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Tag‐less patency capsule for suspected small bowel stenosis: Nationwide multicenter prospective study in Japan
Author(s) -
Nakamura Masanao,
Watanabe Kenji,
Ohmiya Naoki,
Hirai Fumihito,
Omori Teppei,
Tokuhara Daisuke,
Nakaji Konosuke,
Nouda Sadaharu,
Esaki Motohiro,
Sameshima Yukinori,
Goto Hidemi,
Terano Akira,
Tajiri Hisao,
Matsui Toshiyuki
Publication year - 2021
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13673
Subject(s) - medicine , capsule endoscopy , odds ratio , stenosis , capsule , gastroenterology , prospective cohort study , confidence interval , radiology , obscure gastrointestinal bleeding , botany , biology
Study aims The PillCam patency capsule (PPC) is an Agile tag‐less patency capsule used to evaluate gastrointestinal (GI) patency. We determined the appropriate use of PPC to preclude subsequent small bowel capsule endoscopy (SBCE) retention. Methods This prospective multicenter study consecutively enrolled patients indicated for SBCE with suspected or established small bowel stenosis. Excretion of an intact PPC or its radiologic visualization in the large bowel was considered GI patency. Primary and secondary study endpoints were SBCE retention rates in patients with confirmed patency and identification of factors associated with patency and SBCE retention, respectively. Results Of 1096 patients enrolled in the study, patency was confirmed in 976 (89.1%). PPC excretion occurred in 579 patients. Of the remaining 517 patients, patency was confirmed using imaging modalities in 401 (77.5%). SBCE retention occurred in five (0.51%) of 963 patients who underwent SBCE: 1.0% in established Crohn’s disease (CD) patients, 0% in suspected CD, 0% in tumors, and 1.6% in patients with obscure GI bleeding, for which PPC localization had been radiographically misinterpreted. The non‐confirmation of patency was associated with established CD, stenosis identified using imaging modalities, abdominal fullness, serum albumin levels <4.0 g/dL, and previous small bowel obstruction (adjusted odds ratios: 4.21, 2.60, 2.47, 2.12, and 2.00; 95% confidence intervals: 2.62–6.78, 1.62–4.17, 1.43–4.27, 1.32–3.40, and 1.15–3.47, respectively). Conclusions The PillCam™ patency capsule helped preclude SBCE retention in most patients, but its accurate localization was essential for cases without excretion (Study registered the University Hospital Medical Information Network, #UMIN000010513).