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World J Gastroenterol. Dec 7, 2014; 20(45): 16948-16955
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.16948
Colon capsule endoscopy: What we know and what we would like to know
Cristiano Spada, Federico Barbaro, Gianluca Andrisani, Leonardo Minelli Grazioli, Cesare Hassan, Isabella Costamagna, Mariachiara Campanale, Guido Costamagna
Cristiano Spada, Federico Barbaro, Gianluca Andrisani, Leonardo Minelli Grazioli, Cesare Hassan, Isabella Costamagna, Mariachiara Campanale, Guido Costamagna, Department of General Surgery, Digestive Endoscopy Unit, Catholic University, 00168 Rome, Italy
Author contributions: Spada C, Barbaro F, Minelli Grazioli L and Costamagna G designed the study; Andrisani G, Costamagna I and Campanale M made the literature search and the analysis of the results; Spada C, Barbaro F, Andrisani G, Minelli Grazioli L and Hassan C wrote the manuscript; all the Authors were involved in the revision process and approved the final manuscript.
Correspondence to: Cristiano Spada, MD, Department of General Surgery, Digestive Endoscopy Unit, Catholic University, 8 Largo A Gemelli, 00168 Rome, Italy. cristianospada@gmail.com
Telephone: +39-6-30156580 Fax: +39-6-30157220
Received: June 18, 2014
Revised: August 1, 2014
Accepted: September 18, 2014
Published online: December 7, 2014
Processing time: 175 Days and 14.8 Hours
Abstract

Colonoscopy is usually perceived as an invasive and potentially painful procedure, being also affected by a small, but definite, risk of major complications (cardiopulmonary complications, perforation, hemorrhage) and even mortality. To improve both acceptability and safety, PillCam Colon Capsule Endoscopy (CCE) (Given Imaging Ltd, Yoqneam, Israel) has been developed. CCE represents a non-invasive technique that is able to explore the colon without sedation and air insufflation. The Second Generation of Colon Capsule Endoscopy (PillCam Colon 2) (CCE-2) was proven to be an accurate tool to detect colonic neoplastic lesions when used in average risk individuals. To date, the evidence supports the use of CCE-2 in case of colonoscopy failure, in patients unwilling to perform colonoscopy and when colonoscopy is contraindicated. Other potential applications, such as colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease need to be clarified. In this paper, the current “state of the art”, potential application of CCE and future needs are evaluated.

Keywords: Colon capsule endoscopy; Incomplete colonoscopy; Regimen of preparation; Accuracy; Fields of application

Core tip: Colon capsule endoscopy (CCE) allows a minimally invasive, painless colonic investigation without requiring intubation, insufflation or sedation. Indications for CCE are recommended by the European Society of Gastrointestinal Endoscopy guidelines that suggested CCE-2 can be used in average risk patients, in patients with a previous incomplete colonoscopy, in patients unwilling to perform a conventional colonoscopy or in those for whom colonoscopy is not possible or contraindicated. There are issues that still need to be clarified. In the present paper a revision of the literature is provided. Also potential applications and future needs will be discussed.