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Monitoring endoscopic postoperative recurrence in Crohn’s disease after an ileocecal resection. Does capsule endoscopy have a role in the short and long term? Acta Gastroenterol Belg 2022; 85:485-491. [DOI: 10.51821/85.3.10535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Small bowel capsule endoscopy (SBCE) is a noninvasive method to detect endoscopic postoperative recurrence (POR) after an ileocolonic resection in Crohn’s Disease (CD). Few studies have evaluated the role of SBCE in the early POR (= 12 months). Data for detection of late POR (>12 months) and evaluation of treatment response in previous POR is scarce. We aimed to assess the SBCE performance in the three scenarios (early-POR, late-POR, and previous-POR)
Methods: Retrospective 11-year cohort study of SBCE procedures performed on CD patients with ileocolonic resection. Disease activity by Rutgeerts score (RS), correlation with biomarkers, and therapeutic changes were recorded.
Results: We included 113 SBCE procedures (34 early-POR, 44 late-POR, and 35 previous-POR). 105 procedures (92.9%) were complete and 97 SBCE (85.5%) were conclusive with no differences between groups. Relevant POR (RS ≥i2) was more frequent in the early-POR group compared to late-POR (58.8% vs 27.3%, p=0.02). In the previous-POR, RS improved in 43.5% of procedures, worsened in 26%, and remained unchanged in 30.5%. Fecal calprotectin (FCP) value of 100µg/g displayed the best accuracy: sensitivity 53.8%, specificity 78.8%, positive predictive value 66.7% and negative predictive value 68.4%. SBCE guided therapeutic changes in 43 patients (38%). No adverse events occurred in our cohort.
Conclusion: SBCE is a safe and effective method to assess POR in the early and late setting in clinical practice, and for the evaluation of treatment response to previous POR. FCP is an accurate surrogate marker of POR and 100µg/g value had the best overall accuracy.
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Macias E, Elosua A, Fernández-Urién I. One more reason to avoid purgatives before capsule endoscopy examinations: Hypokalemia and low completion rates. Saudi J Gastroenterol 2019; 25:202. [PMID: 30638188 PMCID: PMC6526738 DOI: 10.4103/sjg.sjg_577_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Elena Macias
- Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Alfonso Elosua
- Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Ignacio Fernández-Urién
- Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain,Address for correspondence: Dr. Ignacio Fernandez-Urien, Department of Gastroenterology, Complejo Hospitalario de Navarra, Irunlarrea 3 (Servicio de Digestivo), Pamplona - 31008, Spain. E-mail:
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