Introduction: There is very scarce information about feasibility and safety of video capsule endoscopy (VCE) in patients with and without surgically altered gastrointestinal anatomy (SAGIA). We compared the safety and feasibility of VCE in patients with SAGIA and to those with normal anatomy (NA).
Methods: Methods: Patients undergoing VCE at our Institution were included (2010-2022). Patient with SAGIA undergoing VCE were 2:1 matched based on gender to patients with normal anatomy (NA). SAGIA group comprised of gastrectomy, gastric bypass, enterectomy, colectomy, esophagectomy or Whipple’s procedure. Primary outcome was completion rate, gastric and small bowel transit time and adverse event rate.
Results: Amongst 9584 patients undergoing VCE, 77 patients with SAGIA were matched to 154 patients with NA. Complete data was available for 139 patients with NA which comprised the final control group. Gastric bypass was the most common surgery (n=31 [40.3%]) followed by gastrectomy (complete or partial, n=29 [37.6%]). Video capsule was more likely to be placed by swallowing in SAGIA group in comparison with NA group (76.6% vs. 38.8%, p< 0.001). Patency capsule prior to CE was performed more often in SAGIA group compared to NA group (22.1% vs. 5.0%, p< 0.001).
VCE outcomes are presented in table 1B. Study completion rates were similar between SAGIA and NA (97.4% and 95.5%, p=0.56). Rates of gastric (1.5% vs. 0.7%, p=0.5) and small bowel (1.5% vs. 37%, p=0.6) capsule retention were similar between the SAGIA and NA groups. No patients in either group required intervention for capsule retrieval. Follow up of radiographic imaging was performed more frequently in patients with SAGIA as compared to those with NA (27.3 vs. 3.6%, p< 0.001).
Discussion: VCE is safe in patients with SAGIA with comparable completion rates to patients with NA. Patients with SAGIA undergoing VCE are more likely to undergo patency capsule prior to VCE and radiographic imaging post VCE despite the lower frequency of actual capsule retention in patients with SAGIA. This study did not support routine patency capsule or radiographic follow-up in patients with SAGIA.
