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Small bowel capsule endoscopy in clinical practice: a multicenter 7-year survey. 2010
Emanuele Rondonotti, and
Marco Soncini, and
Carlo Girelli, and
Giovanni Ballardini, and
Guglielmo Bianchi, and
Sergio Brunati, and
Laura Centenara, and
Pietro Cesari, and
Claudio Cortelezzi, and
Simona Curioni, and
Claudio Gozzini, and
Renzo Gullotta, and
Marco Lazzaroni, and
Marta Maino, and
Giovanna Mandelli, and
Nicola Mantovani, and
Elisabetta Morandi, and
Carlo Pansoni, and
Walter Piubello, and
Rocco Putignano, and
Renzo Schalling, and
Maria Tatarella, and
Federica Villa, and
Pasquale Vitagliano, and
Antonio Russo, and
Dario Conte, and
Enzo Masci, and
Roberto de Franchis, and
Università degli Studi di Milano, IRCCS Fondazione Policlinico, Mangiagalli, Regina Elena, Dipartimento di Scienze Mediche, Gastroenterologia 3, Milano, Italy. emanuele.rondonotti@unimi.it
OBJECTIVE Data about small bowel capsule endoscopy (SBCE) come from studies involving small and highly selected populations. The study aim was to describe extent of use, indications, results, complications, and practical issues of SBCE in clinical practice in a Northern Italian Region (Lombardia). METHODS Twenty-three out of 29 invited centers fulfilled a specific questionnaire. RESULTS Between 2001 and 2008, 2921 procedures were performed and both the number of centers performing SBCE (from 5 to 29) and the number of SBCE (from 7.2 to 69.2 per month) increased steadily. The main indications for SBCE were: obscure gastrointestinal bleeding (OGIB) (43.4%), unexplained anemia (23.9%), suspected Crohn's disease (7.8%) and abdominal pain (5.3%). Overall, SBCE was positive in 50% of cases, negative in 36% and undefined in 14%. The highest diagnostic yields were observed in patients with OGIB (62.5%), polypoid syndromes (74.1%), known (54.8%) or suspected (47.3%) inflammatory bowel disease, while the yields were low in patients examined for chronic diarrhea (27.4%) and abdominal pain (14.9%), 61 patients (2.1%) experienced capsule retention. Thirty-two of them eventually excreted the capsule naturally while endoscopic or surgical retrieval was necessary in 29 (1%) (in two because of obstruction). CONCLUSIONS Over a period of 7 years the use of SBCE in Lombardia increased steadily confirming, in clinical practice, a high diagnostic yield and an acceptable safety profile.
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