Colon capsule endoscopy is feasible to perform after incomplete colonoscopy and guides further workup in clinical practice

Background: Colon capsule endoscopy (CCE) could be an option to examine the colon after incomplete colonoscopy.

Objective: To investigate the extent that CCE complements incomplete colonoscopy and guides further workup.

Design: Prospective, follow-up study.

Setting: Three tertiary-care centers.

Patients: Consecutive outpatients after colonoscopy failure; 1-year study period.

Intervention: Patients underwent CCE either immediately after colonoscopy or were rescheduled. Further investigations were guided by the results of CCE. Patients were followed as long as 2 years.

Results: We studied 75 outpatients; 39 had a screening colonoscopy. One third of the patients underwent CCE immediately after colonoscopy. Overall, CCE reached or went beyond the colon segment at which colonoscopy stopped in 68 patients (91%). CCE technically complemented difficult colonoscopy independently of whether same-day CCE was performed (24 [96%]) or was not performed (44 [88%]). CCE detected additional significant findings in 36% of the same-day CCE cases and in 48% of the rescheduled ones. Two patients in the same-day group and 13 in the rescheduled CCE group underwent further colon examination that revealed additional significant findings in 3 of them. Ten percent of the patients reported mild adverse events (AE). If needed, 63 participants (84%) were willing to repeat CCE. Follow-up has not identified symptomatic missed colon cancers.

Limitations: Selected patient population, first-generation colon capsule, old preparation scheme.

Conclusion: CCE performed immediately or at a scheduled date after colonoscopy failure is feasible and safe. CCE after incomplete colonoscopy appears to yield significant findings, guide further workup, and has high patient acceptance.