Year 2025 / Volume 117 / Number 4
Original
Clinical factors influencing patency capsule excretion and confirmation in patients with intestinal patency

179-187

DOI: 10.17235/reed.2024.10706/2024

Shuji Ikegami, Takeshi Yamamura, Masanao Nakamura, Keiko Maeda, Tsunaki Sawada, Eri Ishikawa, Takuya Ishikawa, Kazuhiro Furukawa, Takashi Hirose, Hiroki Kawashima,

Abstract
Introduction: The PillCam™ patency capsule is useful to prevent capsule endoscope retention; however, visual confirmation of patency capsule excretion is challenging for many patients. Objective: We investigated the factors related to the patency capsule remaining in the colon after 33 h and the factors hindering the visual confirmation of its excretion. Methods: We retrospectively analyzed 498 patients with intestinal patency who underwent patency capsule examination. Patients were categorized into the “excretion group” and “colon group,” depending on whether the capsule was excreted or remained in the colon after 33 h, respectively. Patients were further classified into self-confirmed and non-self-confirmed groups within the excretion group. Univariate and multivariate logistic regression analyses were used to analyze the factors associated with the colon and unself-confirmed groups. Results: Overall, 49% of patients visually confirmed capsule excretion within 33 h, whereas 51% did not and required radiological examination. Among those without capsule excretion, 34% of patients had a detectable capsule in the colon, whereas 16% had no detectable capsule. In the excretion group, 75% and 25% of patients were self-confirmed and non-self-confirmed, respectively. Female sex, inpatient status, constipation, and capsule in the colon during the previous examination were independent factors associated with the colon group. Male sex and younger age were the independent factors associated with the non-self-confirmed group. Conclusions: Our findings highlight the need for new approaches to facilitate patency capsule excretion to avoid radiation exposure, especially in females, inpatients, those with constipation, and those with capsule remaining in the colon from the previous examination.
Lay Summary
The PillCam™ patency capsule helps prevent issues with capsule endoscopes getting stuck in the intestine, however, some patients struggle to confirm when the capsule has exited their body visually. This study looked at factors influencing whether the capsule remains in the colon after 33 hours and why some patients cannot visually confirm its excretion. Analyzing data from 498 patients, we found that 49% could visually confirm capsule excretion, while 51% required radiological checks. Factors like being female, being an inpatient, having constipation, and having a previous capsule remaining in the colon were linked to a higher likelihood of the capsule staying in the colon. Men and younger patients were more likely to have trouble confirming capsule excretion visually. The study suggests that new methods are needed to help ensure the reliable exit of capsules from the body and the confirmation by patients, reducing the need for additional imaging and radiation exposure.
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Ikegami S, Yamamura T, Nakamura M, Maeda K, Sawada T, Ishikawa E, et all. Clinical factors influencing patency capsule excretion and confirmation in patients with intestinal patency. 10706/2024


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Publication history

Received: 05/08/2024

Accepted: 22/10/2024

Online First: 07/11/2024

Published: 03/04/2025

Article revision time: 49 days

Article Online First time: 94 days

Article editing time: 241 days


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