Factors predicting conversion from colon capsule endoscopy to conventional optical endoscopy-findings from the...

Area of Science:

• Gastroenterology
• Medical Devices
• Diagnostic Endoscopy

Background:

• Colon capsule endoscopy (CCE) offers a less invasive alternative to traditional colonoscopy for select patients.
• However, CCE's limitations, including low completion rates and inability to perform biopsies, often necessitate conversion to conventional colonoscopy (CCC).

Purpose of the Study:

• To identify predictive factors for bowel cleansing issues, capsule excretion, pathology detection, and CCC.
• To improve patient selection and optimize CCE utilization.

Main Methods:

• Prospective analysis of 603 patients undergoing CCE within the CESCAIL study (Nov 2021-June 2024).
• Examined associations between patient demographics, comorbidities, medications, and laboratory results with CCC.
• Utilized LASSO, linear, and logistic regression for predictive factor analysis.

Main Results:

• Elevated fecal hemoglobin (f-Hb) and smoking were significantly associated with increased CCC rates (OR=1.48 and 1.44, respectively).
• Diabetes correlated with poorer bowel preparation (OR=0.40).
• Alcohol, smoking, psychological conditions, and hemoglobin levels impacted polyp detection; antidepressants and beta-blockers affected polyp size.

Conclusions:

• Non-smokers with lower f-Hb levels demonstrate a reduced likelihood of requiring CCC.
• Optimizing patient selection is crucial for minimizing CCC rates.
• Further validation is needed to develop a CCE Conversion Scoring System (CECS) for improved cost-effectiveness.