TIPS ON CLINICAL IMPLEMENTATION OF COLON CAPSULE ENDOSCOPY

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  • 大腸カプセル内視鏡　実践の工夫

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Abstract

<p>Colon capsule endoscopy (CCE) has received widespread attention as an emerging minimally invasive endoscopic technique that is likely to have an impact on colorectal examination. The sensitivity of CCE has been reported to be 84-94％ and 88-92％ for the detection of polyps ＞＝6mm and ＞＝10mm, respectively.</p><p>Prerequisites for successful CCE examination are adequate cleansing of the bowel and excretion of the capsule within its battery life. Our CCE procedure is as follows. Magnesium citrate is administered in the evening before the CCE procedure. Then, polyethylene glycol solution with ascorbic acid is administered in the morning of the CCE procedure day. If the quality of bowel preparation before ingestion of the capsule is unsatisfactory as assessed by experienced medical staff, an additional laxative is administered and this appears to be crucial for adequate cleansing of the bowel. All patients with satisfactory bowel preparation proceed to capsule ingestion and are administered remaining polyethylene glycol solution with ascorbic acid as a booster after ingesting the capsule. In our approach, dimethicone was shown to be useful in achieving a high cleansing level by dissolving intraluminal air bubbles as bowel preparation and as a booster solution. Recently, adding castor oil in the booster solution was reported to effectively accelerate passage and excretion of the capsule, resulting in an excretion rate within its battery life of close to 100％. We describe our original approach to CCE examination in this paper.</p>

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