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Utility of Hybrid Endoscopy Combining Small-Bowel Capsule Endoscopy and Conventional Ileocolonoscopy in Crohn's
Takahiro Ito1, Kohei Matsunaga1, Yuya Ohno1
1Inflammatory Bowel Disease Center Sapporo Higashi Tokushukai Hospital Hokkaido Japan.
Objectives:
To evaluate the safety and utility of hybrid endoscopy for whole-bowel assessment in Crohn's disease (CD) and its role in treatment decision-making.
Methods:
This single-center retrospective study included 125 patients with CD in clinical remission (Crohn's Disease Activity Index ≤150) who underwent hybrid endoscopy between February 2021 and September 2023. These patients were compared with 53 contemporaneous patients who underwent small-bowel capsule endoscopy (SBCE) alone. Endoscopic remission (ER) was defined as Capsule Endoscopy Crohn's Disease Activity Index <3.5 and Simple Endoscopic Score for Crohn's Disease ≤2. Relapse rates were analyzed according to ER achievement and treatment modification using the Kaplan-Meier method.
Results:
Hybrid endoscopy resulted in a shorter small-bowel transit time (184 min vs. 243 min, p < 0.01) but better bowel cleansing than SBCE alone. Complete small-bowel visualization was achieved in 88.8% of patients following hybrid endoscopy, and 66 of 125 patients achieved ER. Patients without ER who did not undergo treatment intensification displayed significantly higher relapse rates (p = 0.028). Hybrid endoscopy was preferred by 82% of patients.
Conclusions:
This novel hybrid endoscopy approach permits a comprehensive assessment of CD activity using currently available technology. Hybrid endoscopy may be helpful in guiding treatment decisions, particularly treatment intensification in patients who have not achieved ER.
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