Department of Surgery, Raigmore Hospital, Inverness, UK.
Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Colorectal Dis. 2023 Dec;25(12):2383-2391. doi: 10.1111/codi.16771. Epub 2023 Oct 25.
To establish patient factors associated with a successful colon capsule endoscopy (CCE) test.
This prospective cohort study used data collected from patients who underwent CCE as part of the ScotCap evaluation prior to April 2020. A CCE was defined as successful if the capsule visualized the whole colon and rectum (complete test) with sufficient bowel cleansing to permit assessment of the colonic mucosa (adequate bowel preparation). Factors from patients in symptomatic and surveillance groups were analysed for associations with a successful test, complete test, adequate bowel preparation and requirement for further procedure using univariate, multivariate logistic, least absolute shrinkage and selection operator regression.
Data from 263 symptomatic and 137 surveillance patients were analysed. There was an association between a symptomatic patient's age and a successful test (OR = 0.97, 95% CI: 0.95-0.99), adequate bowel preparation (OR = 0.97, 95% CI: 0.94-1.00) and further procedure requirement (OR = 1.04, 95% CI: 1.02-1.06). An association was found, for symptomatic patients, between a faecal immunochemical test result in the range 10-399 μg/g and a further procedure (OR = 2.32, 95% CI: 1.23-4.48). In patients undergoing surveillance for previous colorectal cancer (OR = 0.42, 95% CI: 0.18-0.97), had previous bowel resection surgery (OR = 0.43, 95% CI: 0.19-0.98) or took a beta blocker medication (OR = 0.32, 95% CI: 0.11-0.88), an association was found with further procedure requirement.
Among symptomatic patients, younger age was associated with obtaining a successful CCE test. Clinicians could consider patient selection based on these results to improve the rate of successful testing in clinical practice.
确定与结肠胶囊内镜(CCE)检查成功相关的患者因素。
本前瞻性队列研究使用了 2020 年 4 月前接受 CCE 作为 ScotCap 评估一部分的患者的数据。如果胶囊可视化整个结肠和直肠(完整检查),并且肠道清洁度足以评估结肠黏膜(充分的肠道准备),则将 CCE 定义为成功。对症状组和监测组患者的因素进行分析,以确定与成功检查、完整检查、充分肠道准备和需要进一步检查程序相关的因素,使用单变量、多变量逻辑、最小绝对收缩和选择算子回归。
分析了 263 例症状患者和 137 例监测患者的数据。症状患者的年龄与成功检查(OR=0.97,95%CI:0.95-0.99)、充分的肠道准备(OR=0.97,95%CI:0.94-1.00)和需要进一步检查程序(OR=1.04,95%CI:1.02-1.06)相关。对于症状患者,粪便免疫化学检测结果在 10-399μg/g 范围内与进一步的检查程序(OR=2.32,95%CI:1.23-4.48)相关。在因先前结直肠癌(OR=0.42,95%CI:0.18-0.97)而接受监测的患者、有先前肠道切除术(OR=0.43,95%CI:0.19-0.98)或服用β受体阻滞剂(OR=0.32,95%CI:0.11-0.88)的患者中,发现与进一步检查程序的需求相关。
在症状患者中,年龄较小与 CCE 检查成功相关。临床医生可以根据这些结果选择患者,以提高临床实践中检查成功率。