Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 13, Number 5, October 2020, pages 217-224

Capsule Endoscopy Versus Colonoscopy in Patients With Previous Colorectal Surgery: A Prospective Comparative Study

Figure 1. Colonic acquisitions timeline. Anatomical landmarks used to assess the progression of the capsule along the colon are shown with times of capsule passage. In some cases, landmarks were difficult to recognize due to alterations of the colonic lumen by the surgical resection and anastomosis, which is why these data were not analysed further.

Figure 2. Examples of colonic anastomoses seen on CCE recordings. (a) Ileocolonic anastomosis; (b) Colocolonic anastomosis; (c) Colorectal anastomosis; (d) Colorectal anastomosis with visible surgical staples. CCE: colonic capsule endoscopy.

**Table 1.** Bowel Preparation for CCE-2 and Colonoscopy
Time schedule	Intake
CCE-2: a second generation of colonic capsule endoscopy; PEG: percutaneous endoscopic gastrostomy.
Day - 4 to 0 (each day)	Low residue diet
Day - 2 (evening (8 pm))	Four tablets of 20 mg senna (Pursennide^®)
Day - 1
All day	Clear liquid diet
Evening (7 - 9 pm)	2 L PEG
Day 0 CCE-2 day
6 - 7:30 am	2 L PEG
8:30 - 10 am	Capsule ingestion
After small bowel detection	The first boost (Phospho soda 45 mL (Fleet^®) + 1 L water)
3 h after the first boost	The second boost (Phospho soda 35 mL (Fleet^®) + 1 L water)
2 h after the second boost	Suppository of bisacodyl 10 mg (Dulcolax^®)
8 - 9 pm	1 L PEG
Day 1 colonoscopy (5 - 6:30 am)	2 L PEG

Table 1. Bowel Preparation for CCE-2 and Colonoscopy

Time schedule

Intake

CCE-2: a second generation of colonic capsule endoscopy; PEG: percutaneous endoscopic gastrostomy.

Day - 4 to 0 (each day)

Low residue diet

Day - 2 (evening (8 pm))

Four tablets of 20 mg senna (Pursennide^®)

Day - 1

All day

Clear liquid diet

Evening (7 - 9 pm)

2 L PEG

Day 0 CCE-2 day

6 - 7:30 am

2 L PEG

8:30 - 10 am

Capsule ingestion

After small bowel detection

The first boost (Phospho soda 45 mL (Fleet^®) + 1 L water)

3 h after the first boost

The second boost (Phospho soda 35 mL (Fleet^®) + 1 L water)

2 h after the second boost

Suppository of bisacodyl 10 mg (Dulcolax^®)

8 - 9 pm

1 L PEG

Day 1 colonoscopy (5 - 6:30 am)

2 L PEG

**Table 2.** Patient Characteristics at Inclusion
Patient characteristics	Number (intent to treat, n = 37)	Number (per protocol, n = 32)
SD: standard deviation.
Gender
Male	20	17
Female	17	15
Age (years, mean ± SD)	63 ± 10	62 ± 10
Previous colorectal surgery	37 (100%)	32 (100%)
Reason for exclusion
Absence of anastomosis	1
Contraindication to anaesthesia	2
Contraindication to colonoscopy	1
Extremely fast progression of the capsule through the colon	1
Reason for previous colorectal surgery
Colorectal cancer	18 (48.6%)	16 (50.0%)
Diverticula	15 (40.5%)	14 (43.8%)
Constipation	2 (5.4%)	2 (6.2%)
Colonic polyp	2 (5.4%)	-
Type of anastomosis
Ileocolonic	8 (21.6%)	7 (21.9%)
Colocolonic	2 (5.4%)	1 (3.1%)
Colorectal	26 (70.3%)	24 (75.0%)
Wedge resection	1 (2.7%)	-

Table 2. Patient Characteristics at Inclusion

Patient characteristics

Number (intent to treat, n = 37)

Number (per protocol, n = 32)

SD: standard deviation.

Gender

Male

Female

Age (years, mean ± SD)

63 ± 10

62 ± 10

Previous colorectal surgery

37 (100%)

32 (100%)

Reason for exclusion

Absence of anastomosis

Contraindication to anaesthesia

Contraindication to colonoscopy

Extremely fast progression of the capsule through the colon

Reason for previous colorectal surgery

Colorectal cancer

18 (48.6%)

16 (50.0%)

Diverticula

15 (40.5%)

14 (43.8%)

Constipation

2 (5.4%)

2 (6.2%)

Colonic polyp

2 (5.4%)

Type of anastomosis

Ileocolonic

8 (21.6%)

7 (21.9%)

Colocolonic

2 (5.4%)

1 (3.1%)

Colorectal

26 (70.3%)

24 (75.0%)

Wedge resection

1 (2.7%)

**Table 3.** Detection of the Surgical Anastomosis With CCE-2 and at Colonoscopy
Type of anastomosis	N	CCE-2	Colonoscopy
CCE-2: a second generation of colonic capsule endoscopy.
Ileocolonic	8	7	1	8	-
Colocolonic	1	1	-	1	-
Colorectal	23	17	6	21	2

Table 3. Detection of the Surgical Anastomosis With CCE-2 and at Colonoscopy

Type of anastomosis

CCE-2

Colonoscopy

Accurately described

Not detected

Accurately described

Not detected

CCE-2: a second generation of colonic capsule endoscopy.

Ileocolonic

Colocolonic

Colorectal

**Table 4.** Colonic Lesions Detected by CCE-2 and Colonoscopy
	CCE-2 findings	Colonoscopy findings	Total number of lesions
CCE-2: a second generation of colonic capsule endoscopy.
Polyps	15	17	18
Diverticulosis	16	16	18
Lipoma	2	2	2

Table 4. Colonic Lesions Detected by CCE-2 and Colonoscopy

CCE-2 findings

Colonoscopy findings

Total number of lesions

CCE-2: a second generation of colonic capsule endoscopy.

Polyps

Diverticulosis

Lipoma