Camera Capsule Endoscopy in the Routine Diagnostic Pathway for Colorectal Diseases

Summary

The Department of Surgery at Odense University Hospital (OUH) carries out approximately 10,000 colonoscopies each year, and this number is continuously increasing. Since 2014, the screening for colorectal cancer (CRC) has resulted in a significant increase in the colonoscopy workload. Conventional colonoscopy (CC) is a hospital-based procedure that can require sedation or analgesics and is often considered uncomfortable, intimidating, or even painful. The diagnostic yield of CC can be as low as 3-5% in some patient groups, which means that an endoscopist may need to perform 20 to 30 colonoscopies to identify one case requiring treatment. Physical or cultural barriers can also deter patients from attending appointments, leading to missed cancers or precancerous lesions. To address these challenges, an alternative pathway is needed to reduce the colonoscopy burden on the healthcare system while ensuring fewer findings are missed. One solution is to use Colon Capsule Endoscopy (CCE) as a triage tool. This procedure can be performed in outpatient healthcare centers and requires less equipment than an CC. However, CCE offers no therapeutic capability, and individuals with clinically significant findings will still require an CC. A low reinvestigation rate (\<25%-30%) is desirable for patient preference and the economy. Therefore, DanCap will introduce a new pathway that relies on CCE for routine colorectal examinations of symptomatic patients who are expected to have a low rate of positive findings and, consequently, a low reinvestigation rate, and asses the cost of this new pathway.

Eligibility

Inclusion Criteria:

* Older than 18 years
* Symptomatic patient referred for colonoscopy assessment
* Able to provide oral and written informed consent

Exclusion criteria

1. Require hospital admission for inpatient colonoscopy
2. Previous OC with poor bowel preparation within the last 5 years
3. Patient is unable to provide oral and written informed consent
4. History of stenosis of the digestive tract
5. Previous major surgery of the digestive tract with consequence of an internal derivation or a stoma\*
6. Patient has a pacemaker/defibrillator
7. Patient is pregnant or breastfeeding
8. Known allergies to the bowel preparation regimen
9. Have severe kidney disease
10. Known chronic constipation
11. Imaging examination suggestive for a colorectal tumour
12. Anamnestic suspicion of microscopic colitis, where biopsy is needed \*including Whipple

Conditions2

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