Endoscopic capsule placement improves the completion rate of small-bowel capsule endoscopy and increases diagnostic yield

Background: The methods for increasing the rate of complete small-bowel examinations by capsule endoscopy; (CE) demonstrate conflicting results, and it is unknown whether improving the completion rate of CE transit is correlated with improvement in diagnostic yield. Objective: The aim of this study was to determine whether a higher rate of complete small-bowel examinations results in a higher diagnostic yield of CE. Design: Case-control comparison. Setting: Tertiary care university hospital. Patients: A total of 273 patients underwent conventional CE (group A), and 261 patients underwent real-time CE (group B). Furthermore, the patients in groups A and B were divided into 2 subgroups by pyloric transit time (A1, A2 and B1, B2, respectively). Interventions: After swallowing the capsule, each patient was monitored with a real-time viewer in group B, and the patients underwent endoscopic placement if the capsule was delayed in the esophagus or stomach. Main Outcome Measurements: Pyloric transit time, small-bowel transit time, the rate of complete small-bowel examinations, and the diagnostic yield. Results: The rate of complete small-bowel examinations was significantly higher in group B than in group A (87.4% vs 78.0%, respectively; P = .004). The diagnostic yield was significantly higher in group 132 than in group A2 (60.0% vs 41.7%, respectively; P = .019). Limitations: Nonrandomized study. Conclusions: Endoscopic placement improves the rate of complete small-bowel examinations, resulting in a higher diagnostic yield of CE. (Gastrointest Enclose 2010;72:103-8.)