P3010 - Results From a New Colon Capsule Endoscopy Service

Peter McMahon, MBChB, Anirudh P. Bhandare, MBBS, Rizwan Diyar, MBBS, Kimberley A. Butler, MBChB
Northern Care Alliance, Oldham, England, United Kingdom

Introduction: NHS England introduced colon capsule endoscopy (CCE) as alternative to traditional colonoscopy in select patients. CCE is preferred by patients, associated with lower risk and can be carried out remotely. However, CCE should be used for patients where there is a low risk of subsequent intervention being required to avoid multiple procedures. This retrospective study looks at the data from a newly established centre.

Methods: CCE was offered to patients who were referred on the 2-week wait (2WW) colorectal pathway with FIT < 100 and to post-polypectomy surveillance patients. Patients were referred with NG12 symptoms. Patients received Senna and PEG preparation (MOVIPREP) as bowel preparation. Bowel preparation was graded 1-3 in each segment of colon. Metoclopramide or prucalopride were used as a prokinetic. The primary outcomes in our retrospective study were symptoms at referral, bowel preparation score, FIT test results, completion rate, and requirement for subsequent investigations.

Results: 249 patients met criteria and agreed to have CCE. 5 were excluded due to lack of information available, or consent withdrawn by patient. Of the remaining patients (n=244), 121 were Male (49.5%). Median age was 57. 240 were referred with NG12 symptoms and 4 were post-polypectomy surveillance. Patients were referred with change in bowel habit (n=150), abdominal pain (n=90), PR bleeding (n=81), anaemia (n=50), and weight loss (n=47). 116 patients had a negative FIT test. Of positive FIT results (n=129), the mean was 30. Mean bowel preparation score was 7.4. 209 (85.7%) had a satisfactory bowel preparation score (≥6). 72.1% (n=178) had a complete examination and 71% (n=171) were stepped down off the 2WW pathway. Reasons for incomplete examination were insufficient camera battery (n=34), poor bowel preparation (n=28), camera error (n=2), rapid transit (n=1), camera stuck in stomach (n=1), camera expulsion due to vomiting (n=1), and inability to swallow camera (n=1). To complete the investigation the incomplete patients had colonoscopy (n=41), flexible sigmoidoscopy (n=21), CT colonography (n=2), no further investigation (n=3), and refused further tests (n=1).

Discussion: CCE has become a viable alternative to traditional colonoscopy, but more research is needed to identify the correct patients. Further analysis of this patient group will aim to identify which patients benefit from CCE. These patients will be followed up to ensure no missed cancer diagnosis.


Disclosures:


Peter McMahon, MBChB, Anirudh P. Bhandare, MBBS, Rizwan Diyar, MBBS, Kimberley A. Butler, MBChB. P3010 - Results From a New Colon Capsule Endoscopy Service, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.