Video capsule endoscopy may be useful for surveillance of small-bowel polyps in patients with familial adenomatous polyposis.
Dr Robert Wong and colleagues from Utah compared video to standard endoscopy for diagnosing small-bowel polyps.
The researchers compared the techniques in a defined segment of small bowel, proximal to a tattoo, and the entire examined small bowel.
The research team conducted a prospective study in a single tertiary referral center in 32 participants with familial adenomatous polyposis.
The majority were selected for their high number of proximal small-bowel polyps and prior endoscopic tattoo placement in the proximal small bowel.
Video capsule endoscopy, push enteroscopy, and lower endoscopy were used to count and measure small-bowel polyps.
|In the defined segment, video capsule endoscopy detected a median of 10 polyps|
In the defined segment, video capsule endoscopy detected a median of 10 and 9 polyps for each reviewer vs a median of 41 polyps on push endoscopy.
The researchers reported that agreement between the 2 methods was fair.
The team noted that agreement between video capsule endoscopy and push enteroscopy was poor to fair for estimating the size of the largest polyp.
The agreement between video capsule endoscopy and push enteroscopy was poor for detecting large polyps.
In the entire examined small bowel, each of the 2 reviewers identified that video capsule endoscopy diagnosed a median of 38 and 54 polyps, respectively.
The research team found that combination endoscopy diagnosed a median of 123 polyps.
Agreement between the 2 methods was fair to moderate.
The team reported that results may not be applicable to all patients with familial adenomatous polyposis.
Dr Wong's team comments, “Capsule endoscopy underestimates the number of small-bowel polyps in persons with familial adenomatous polyposis, and does not reliably detect large polyps.”