P157. The clinical efficacy of novel tag-less Agile Patency Capsule (Agile‑J) for Crohn's disease patients with suspected or known intestinal stricture prior to capsule endoscopy procedure, a prospective, open-label study
K. Watanabe1, K. Morimoto1, N. Ohmiya2, M. Nakamura2, H. Goto2, T. Arakawa1
1Osaka City University Graduate School of Medicine, Gastroenterology, Osaka, Japan; 2Nagoya University Graduate School of Medicine, Gastroenterology, Nagoya, Japan
Background: The efficacy of Agile Patency Capsule for avoiding retention of capsule endoscopy (CE) has been reported. But it cannot be totally denied that there might be possibilities that the RFID-tag in Agile Patency Capsule might stay in the small bowel leading to obstruction. We investigated the efficacy of the novel tag-less Agile Patency Capsule (Agile‑J) for mainly established Crohn's disease (CD) patients with suspected or known intestinal stricture.
Methods: The confirmation of patency of the small bowel by Agile‑J was conducted at 30 hours after ingestion of Agile‑J. If the confirmation at 30 hours was not successful, reconfirmation was performed within 72 hours after the ingestion. And we performed balloon enteroscopy for patients that Agile‑J could not confirm the patency to evaluate the reasons for it. The primary endpoint of the study is to calculate the rate of CE retention in patients with confirmed patency by Agile‑J.
Results: Fifty-six patients were included (mean age: 42.8, male: 33) in the study. Established CD was 33 cases, Suspected CD was 2 cases, intestinal Behçet's disease was 3 cases and the others. Forty-three cases (76.8%) had complete Agile‑J examination followed by CE within 2 weeks. In thirty-one cases (72.1%) of them, the pathologic findings were found by CE. And in thirty-two (74.4%) of them, total enteroscopy was performed. The time of discharge of Agile‑J was correlated with the time of discharge of CE followed. In eighteen cases (32.1%), the patency could not be confirmed at 30 hours after the ingestion. In addition to stricture, it became clear that Agile‑J could not confirm the petency in the patients with severe adhesion using balloon enteroscopy procedure. In case of established CD, 22 cases (66.7%) were confirmed with Agile‑J, and in 18 cases (81.8%) of them CE lesions were found by CE followed. In thirteen cases (59.1%), total enteroscopy was performed. After the confirmation of the patency by Agile‑J, retention occurred in one established CD case. The patient had prior severe abdominal pain which may have been related to ileal obstruction. There is no difficulty for tag-less Agile Patency Capsule to confirm the patency of the small bowel for capsule endoscopy procedure.
Conclusions: The novel Agile‑J was useful to evaluate the patency of the small bowel to confirm the safer capsule endoscopy procedure in patients with CD. The cases with severe abdominal pain could be a risk for retention even though Agile‑J confirmed the patency.