Gomes C, Pinho R, Rodrigues A, Ponte A, Silva J, Rodrigues JP, Sousa M, Silva JC, Carvalho J. Impact of the timing of capsule endoscopy in overt obscure gastrointestinal bleeding on yield and rebleeding rate - is sooner than 14 d advisable? World J Gastrointest Endosc 2018; 10(4): 74-82 [PMID: 29666667 DOI: 10.4253/wjge.v10.i4.74]
Corresponding Author of This Article
Catarina Gomes, MD, Doctor, Department of Gastroenterology, Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, Vila Nova de Gaia, Porto 4434502, Portugal. catarina.rib.gomes@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Apr 16, 2018; 10(4): 74-82 Published online Apr 16, 2018. doi: 10.4253/wjge.v10.i4.74
Impact of the timing of capsule endoscopy in overt obscure gastrointestinal bleeding on yield and rebleeding rate - is sooner than 14 d advisable?
Catarina Gomes, Rolando Pinho, Adélia Rodrigues, Ana Ponte, Joana Silva, Jaime Pereira Rodrigues, Mafalda Sousa, João Carlos Silva, João Carvalho
Catarina Gomes, Rolando Pinho, Adélia Rodrigues, Ana Ponte, Joana Silva, Jaime Pereira Rodrigues, Mafalda Sousa, João Carlos Silva, João Carvalho, Department of Gastroenterology, Centro Hospitalar Vila Nova de Gaia/Espinho, Porto 4434502, Portugal
Author contributions: Gomes C and Pinho R designed the study, performed the research, analyzed the data and wrote the paper; Rodrigues A, Ponte A, Silva J, Rodrigues JP, Sousa M, Silva JC and Carvalho J performed the research and analyzed the data.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Catarina Gomes, MD, Doctor, Department of Gastroenterology, Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, Vila Nova de Gaia, Porto 4434502, Portugal. catarina.rib.gomes@gmail.com
Telephone: +351-22-7865100 Fax: +351-22-7868369
Received: December 3, 2017 Peer-review started: December 4, 2017 First decision: December 22, 2017 Revised: January 18, 2018 Accepted: March 14, 2018 Article in press: March 15, 2018 Published online: April 16, 2018 Processing time: 133 Days and 16.3 Hours
ARTICLE HIGHLIGHTS
Research background
An early diagnosis with capsule endoscopy in overt-obscure gastrointestinal bleeding patients can lead to an appropriate specific intervention, better long term-outcomes and reduce unnecessary medical costs. European Society of Gastrointestinal Endoscopy recommends performing capsule endoscopy as soon as possible after the bleeding episode, optimally within 14 d. In this paper we evaluated the impact of the timing of capsule endoscopy in these patients, focusing in an earlier evaluation.
Research motivation
As an earlier diagnosis could lead to an earlier and more effective therapy, the authors ought to evaluate the impact of an earlier capsule evaluation on the therapeutic yield and the rebleeding rate.
Research objectives
To evaluate how the timing of capsule endoscopy (CE) in overt-obscure gastrointestinal bleeding (OGIB) could change management of overt-OGIB and future outcomes.
Research methods
The diagnostic and therapeutic yield (DY and TY) rebleeding rate, time to rebleed and mortality were calculated and compared according to the timing of capsule endoscopy (≤ 48 h; 48 h-14 d and ≥ 14 d).
Research results
Despite a similar diagnostic yield, performing capsule endoscopy within 48 h is associated with greater therapeutic yield, less rebleeding episodes, and a longer rebleeding-free time. This suggests that a more timely approach than the 14 d recommendation in the evaluation of overt-OGIB should be considered.
Research conclusions
Performing CE within 48 h from the onset of overt-OGIB is associated with a higher therapeutic yield, a lower rebleeding rate and a longer rebleeding-free time. It raises the question that performing CE sooner than 14 d could be advisable.
Research perspectives
Our study has a retrospective design with a small number of patients, so a prospective assessment of this timing of CE in overt-OGIB in a larger population is warranted to confirm these findings and change recommendations.
