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Original article
Clinical utility of the small bowel capsule endoscopy in the study of small bowel diseases in Colombia: Results of a national registry
Utilidad clínica de la videocápsula endoscópica en el estudio de patologías de intestino delgado en Colombia: resultados de un registro nacional
Fabián Juliao-Bañosa,
Corresponding author
fabianjuliao@hotmail.com

Corresponding author.
, María T. Galianob, Joselyn Camargoc, Gabriel Mosquera-Klingera, Jhon Carvajala, Claudia Jaramillod, Luis Sabbaghd, Héctor Curee, Fernando Garcíaf, Benedicto Velascog, Camilo Manriqueg, Viviana Parrah, Cristian Flórezh, José Bareñoi
a Hospital Pablo Tobón Uribe, Medellín, Colombia
b MTG Servimed SAS, Bogotá, Colombia
c Fellow de Gastroenterología, Universidad CES, Medellín, Colombia
d Clínica Reina Sofía, Fundación Universitaria Sanitas, Bogotá, Colombia
e Clínica General del Norte, Barranquilla, Colombia
f Universidad de Cartagena, Cartagena, Colombia
g Gastromedicall, Bogotá, Colombia
h Gastroadvanced, Bogotá, Colombia
i Universidad CES, Medellín, Colombia
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        "titulo" => "Utilidad cl&#237;nica de la videoc&#225;psula endosc&#243;pica en el estudio de patolog&#237;as de intestino delgado en Colombia&#58; resultados de un registro nacional"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Patient origin and complete visualisation of SB&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Since its launch as a diagnostic tool in 2000&#44; video capsule endoscopy &#40;VCE&#41; has revolutionised the study of small bowel &#40;SB&#41; disease all over the world&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> VCE enables the SB to be visualised in patients with a broad spectrum of disorders&#44; from obscure gastrointestinal bleeding &#40;OGIB&#41; to Crohn&#8217;s disease &#40;CD&#41;&#44; hereditary polyposis syndromes and coeliac disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The term OGIB&#44; defined as gastrointestinal bleeding in subjects with normal upper GI endoscopy and colonoscopy&#44; has recently been changed to potential small bowel bleeding &#40;SBB&#41;&#46; This type of bleeding is classified as&#58; visible or overt&#44; due to the presence of bleeding from the mouth&#44; manifesting as haematemesis&#44; or rectum&#44; manifesting as haematochezia or melaena&#59; or occult&#44; defined as persistence of positive faecal occult blood and&#47;or iron deficiency anaemia &#40;IDA&#41;&#44; with no evidence of visible bleeding&#46; The term OGIB is currently reserved only for patients with gastrointestinal bleeding of unknown origin after a complete evaluation of the gastrointestinal tract with upper endoscopy&#44; total colonoscopy and SB studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In patients with suspected SBB&#44; VCE has become a very important diagnostic method in recent years&#46; One systematic review found that OGIB was the most common indication &#40;66&#46;0&#37;&#41;&#44; with a lesion detection rate of 60&#46;5&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Another systematic review&#44; which included only patients with IDA with previous normal upper endoscopy and colonoscopy&#44; found a diagnostic yield of 47&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> In CD&#44; VCE had a better diagnostic performance than ileoscopy&#44; intestinal transit and CT enterography&#44; but no significant difference was found compared to magnetic resonance enterography&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> VCE is indicated in patients with coeliac disease who have unexplained symptoms despite adequate treatment&#44; due to its high sensitivity and specificity in the study of this disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3&#44;9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Despite being a safe procedure&#44; VCE is not without complications&#46; Complications such as aspiration and capsule retention in the stomach or SB have been reported&#44; requiring medical&#44; endoscopic or surgical management&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Various isolated studies with VCE at prominent centres here in Colombia have been published&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#8211;14</span></a> However&#44; we believe a national study is necessary that includes the vast majority of centres with experience in this endoscopic procedure in our country&#46; The aim of this study was to determine the indications for VCE&#44; and the associated findings&#44; diagnostic performance&#44; complications and management approach after completion&#44; among patients having this procedure in Colombia&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Type of study</span><p id="par0030" class="elsevierStylePara elsevierViewall">This was a multicentre&#44; observational&#44; analytical cross-sectional study with a retrospective approach&#46; A call was put out to all hospital and outpatient centres that perform VCE here in Colombia&#44; and we were able to include the most prominent centres with the most experience in VCE in the country&#46; All VCEs performed in the different centres from January 2006 to October 2019 were included&#46; The seven participating centres&#44; with their respective city of origin&#44; and the number of VCE studies that contributed to the national registry &#40;in brackets&#41;&#44; were as follows&#58; Hospital Pablo Tob&#243;n Uribe&#44; Medell&#237;n &#40;668&#41;&#44; Servimed SAS MTG&#44; Bogot&#225; &#40;479&#41;&#44; Fundaci&#243;n Universitaria Sanitas&#44; Bogot&#225; &#40;284&#41;&#44; Cl&#237;nica General del Norte&#44; Barranquilla &#40;195&#41;&#44; Universidad de Cartagena&#44; Cartagena &#40;134&#41;&#44; Gastromedical&#44; Bogot&#225; &#40;69&#41; and Gastroadvanced&#44; Bogot&#225; &#40;54&#41;&#46; Data from all patients with a VCE study due to suspected SB disease at the above hospital and outpatient centres were included retrospectively&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Data collection</span><p id="par0035" class="elsevierStylePara elsevierViewall">A database was constructed using Excel which was distributed to each participating centre&#44; and the following variables were collected from each VCE study for analysis&#58; &#40;1&#41; patient identification&#59; &#40;2&#41; institution&#59; &#40;3&#41; study date&#59; &#40;4&#41; date of birth&#59; &#40;5&#41; patient gender&#59; &#40;6&#41; indication for the procedure&#59; &#40;7&#41; origin of the patient &#40;outpatient or hospital&#41;&#59; &#40;8&#41; preparation prior to the procedure&#59; &#40;9&#41; model of VCE used&#59; &#40;10&#41; mode of advancing to the duodenum&#59; &#40;11&#41; qualitative quality of the preparation&#59; &#40;12&#41; type of lesions found&#59; &#40;13&#41; location of lesions&#59; &#40;14&#41; clinical relevance of the lesion&#59; &#40;15&#41; complete visualisation of the SB&#59; &#40;16&#41; presence of complications&#59; &#40;17&#41; management of complications&#59; and &#40;18&#41; medical approach post-VCE&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">All the patients at the different centres were prescribed a liquid diet the day before and were prepared with polyethylene glycol at a dose of 2<span class="elsevierStyleHsp" style=""></span>L the night before the study&#46; Patients who did not receive preparation were advised to adhere to a clear liquid diet the day before the study&#46; To measure the quality of the SB preparation&#44; a previously validated qualitative scale was used which is divided into four categories - excellent&#44; good&#44; fair and poor - depending on the percentage of visualisation of the mucosa&#44; its brightness&#44; and the presence of debris and bubbles in the intestinal lumen&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> The study was considered a complete SB VCE when the capsule reached the colon during the recording&#44; and capsule retention in SB was defined as when the capsule still remained in the SB 15 days after the study&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> The relevance of the lesions was documented according to their potential to cause bleeding&#44; according to Saurin&#8217;s classification&#58; P0 - lesions without bleeding potential such as phlebectasia&#44; bloodless diverticula&#44; or subepithelial lesions without erosion of the mucosa&#59; P1 - lesions with uncertain bleeding potential&#44; within which are &#8220;red spots&#8221;&#44; small or isolated erosions&#59; and lastly&#44; P2 - lesions with high bleeding potential&#44; such as angioectasia&#44; ulcers&#44; tumours or varicose veins&#46; In order to determine the diagnostic yield&#44; P1 and P2 lesions have to be taken into account&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">A univariate analysis was initially performed where absolute and relative frequencies were used for qualitative variables&#44; and mean and standard deviation or median and interquartile range &#40;P25&#8722;75&#41; were used for quantitative variables&#44; after verification of the assumption of normality&#46; The quantitative variables were dichotomised and it was decided to make a comparison of proportions and so the Chi-square test of independence or Fischer&#8217;s test was used and the odds ratio &#40;OR&#41; was estimated with its respective 95&#37; confidence interval&#46; In all cases&#44; a p-value &#60;0&#46;05 was considered as statistically significant&#46; We used the freely available JAMOVI statistical package and Epidat version 3&#46;1&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical considerations</span><p id="par0050" class="elsevierStylePara elsevierViewall">This research involved no risk&#44; as we only used the information sent by the researchers from their clinical practice&#44; where the confidentiality and privacy of the information collected was guaranteed&#46; The project researchers adhered to the international principles of the Declaration of Helsinki &#40;version 2013&#44; Fortaleza&#44; Brazil&#41; and Colombian Ministry of National Health resolution 008430 of 1993&#46; The study was approved by the ethics committee of each participating centre&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">According to articles 10 and 11 of the above Resolution 008430 of 1993&#44; the research is considered to come under the classification of being free of risk&#44; and it is also a secondary-source study&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">We analysed 1&#44;883 VCEs performed to investigate SB disease&#44; from different centres around the country &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Out of all the procedures&#44; 1&#44;127 &#40;59&#46;9&#37;&#41; were performed in females and 756 &#40;40&#46;1&#37;&#41; in males&#46; The mean age was 55&#46;4 &#40;SD&#58; 18&#46;5&#41; with a range of 5&#46;6&#8211;94&#46;2 years&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">The most common indications for the VCE were suspected SBB in 1&#44;212 &#40;64&#46;4&#37;&#41;&#44; 655 &#40;34&#46;8&#37;&#41; of whom had occult SBB and 557 &#40;29&#46;6&#37;&#41; overt SBB&#44; investigation of CD in 286 &#40;15&#46;2&#37;&#41; and chronic diarrhoea in 210 &#40;11&#46;2&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The VCE systems used were Medtronic SB2 and SB3 &#40;96&#46;0&#37;&#41;&#44; CapsoCam &#40;3&#46;5&#37;&#41; and Olympus EndoCapsule &#40;0&#46;5&#37;&#41;&#46; In 1&#44;024 &#40;54&#46;3&#37;&#41; of the VCEs&#44; laxatives were given for pre-procedure SB preparation &#40;polyethylene glycol was used in 94&#46;0&#37;&#41;&#46; In 859 &#40;45&#46;6&#37;&#41; of the cases&#44; there was no preparation prior to the procedure&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The qualitative quality of the SB mucosa preparation was considered excellent in 334 &#40;17&#46;7&#37;&#41;&#44; good in 1&#44;416 &#40;75&#46;2&#37;&#41;&#44; fair in 111 &#40;5&#46;9&#37;&#41; and poor in 22 &#40;1&#46;2&#37;&#41;&#46; For the VCEs in which bowel preparation was carried out&#44; the quality was classified as excellent&#47;good in 94&#46;8&#37; vs 90&#46;7&#37; in the studies with no preparation&#46; This difference was significant &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;9&#59; 95&#37; CI&#58; 1&#46;3&#8211;2&#46;7&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#60;0&#46;001&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Out of 1&#44;883 VCEs&#44; lesions were detected in 1&#44;421 &#40;75&#46;5&#37;&#41; and 462 &#40;24&#46;5&#37;&#41; were normal&#46; The lesions found were as follows&#44; in order of frequency with percentage of the total number of VCEs performed&#58; erosions&#47;ulcers &#40;31&#46;6&#37;&#41;&#59; angioectasias &#40;25&#46;7&#37;&#41;&#59; active bleeding without lesion &#40;3&#46;1&#37;&#41;&#59; old bleeding without lesion &#40;1&#46;6&#37;&#41;&#59; lymphangiectasia &#40;5&#46;6&#37;&#41;&#59; parasites &#40;2&#46;7&#37;&#41;&#59; masses&#47;tumours &#40;2&#46;3&#37;&#41;&#59; polyps &#40;2&#46;2&#37;&#41;&#59; villous atrophy &#40;2&#46;2&#37;&#41;&#59; xanthoma &#40;2&#46;0&#37;&#41;&#59; phlebectasia &#40;1&#46;9&#37;&#41;&#59; non-steroidal anti-inflammatory drug-induced enteropathy &#40;1&#46;5&#37;&#41;&#59; small bowel stricture &#40;0&#46;6&#37;&#41;&#59; intestinal diverticula &#40;0&#46;5&#37;&#41;&#59; Meckel&#8217;s diverticulum &#40;0&#46;3&#37;&#41;&#59; portal hypertensive enteropathy &#40;0&#46;2&#37;&#41;&#59; and blue rubber nevus &#40;0&#46;3&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; In 268 &#40;14&#46;2&#37;&#41; of the VCEs more than one type of lesion was found&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Lesions were also found in sites other than the SB&#46; Oesophageal lesions were found in 13 &#40;0&#46;7&#37;&#41; of the VCEs - 7 oesophageal varices&#44; 2 erosive oesophagitis&#44; 2 angioectasia and 1 oesophageal polyp&#46; Gastric lesions were found in 52 &#40;2&#46;8&#37;&#41; - 32 erosive gastritis&#44; 13 angioectasia&#44; 5 active bleeding and 2 phlebectasia&#46; Lastly&#44; colonic lesions were found in 60 &#40;3&#46;2&#37;&#41; - 20 angioectasia&#44; 5 active bleeding&#44; 4 old bleeding&#44; 19 erosive colitis&#44; 1 colon cancer&#44; 5 polyps&#44; 2 parasites and 3 diverticular disease&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Sorting the detection rate by indication&#44; of the 1&#44;212 VCEs requested for suspected SBB&#44; lesions were detected in 962 &#40;79&#46;3&#37;&#41;&#44; the most common being angioectasia in 345 cases &#40;35&#46;9&#37;&#41;&#44; followed by erosions&#47;ulcers in 148 &#40;15&#46;4&#37;&#41;&#46; Of the 655 VCEs requested for suspected occult SBB&#44; lesions were detected in 511 &#40;78&#46;0&#37;&#41;&#44; the most common being angioectasia &#40;187&#59; 36&#46;6&#37;&#41;&#44; followed by erosions&#47;ulcers &#40;132&#59; 25&#46;8&#37;&#41;&#46; Of the 557 VCEs requested for suspected overt SBB&#44; lesions were detected in 451 &#40;76&#46;8&#37;&#41;&#44; the most common being angioectasia &#40;159&#59; 35&#46;3&#37;&#41;&#44; followed by erosions&#47;ulcers &#40;121&#59; 26&#46;9&#37;&#41;&#46; Of the 286 VCEs requested for suspected SB CD&#44; lesions were detected in 235 &#40;82&#46;1&#37;&#41;&#44; the most common being erosions&#47;ulcers &#40;153&#59; 65&#46;3&#37;&#41;&#44; followed by angioectasia &#40;43&#59; 18&#46;3&#37;&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">More angioectasias were found in VCEs indicated for suspected SBB&#44; compared to VCEs for investigation of CD&#44; and this difference was significant &#40;OR&#58; 2&#46;24&#59; 95&#37; CI 1&#46;6&#8211;3&#46;2&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#46; The VCEs indicated for investigation of CD detected more erosions&#47;ulcers compared to those for suspected SBB&#44; with this difference also being significant &#40;OR&#58; 4&#46;24&#59; 95&#37; CI 3&#46;23&#8211;5&#46;56&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Of the total of 1&#44;212 VCEs indicated for suspected SBB&#44; 250 were negative &#40;20&#46;6&#37;&#41;&#44; 227 &#40;18&#46;7&#37;&#41; showed P0 lesions&#44; 372 &#40;30&#46;7&#37;&#41; P1 and 363 &#40;29&#46;9&#37;&#41; with P2&#46; The diagnostic yield &#40;P1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>P2&#41; of VCE for this group of patients was 60&#46;6&#37;&#46; Of the 655 VCEs requested for suspected occult SBB&#44; 144 &#40;21&#46;9&#37;&#41; showed P0 lesions&#44; 217 &#40;33&#46;1&#37;&#41; P1 and 150 &#40;22&#46;9&#37;&#41; P2&#44; for a diagnostic yield of 56&#46;0&#37;&#46; Of the 557 VCEs requested for suspected overt SBB&#44; 83 &#40;14&#46;9&#37;&#41; showed P0 lesions&#44; 155 &#40;27&#46;8&#37;&#41; P1 and 213 &#40;38&#46;2&#37;&#41; P2&#44; for a diagnostic yield of 66&#46;0&#37;&#46; VCEs indicated for suspected overt SBB had a higher diagnostic yield than those for occult SBB&#44; and this difference was significant &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">In the VCE studies in which bowel preparation was excellent&#47;good&#44; a higher rate of SB lesions was detected than in those with fair&#47;poor preparation &#40;93&#46;8&#37; vs 89&#46;4&#37;&#41;&#44; and this difference was significant &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;8&#59; 95&#37; CI&#58; 1&#46;2&#8211;2&#46;6&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; In 1&#44;819 &#40;96&#46;6&#37;&#41; of the VCEs&#44; complete SB visualisation was achieved&#44; while in 64 &#40;3&#46;4&#37;&#41; it was incomplete&#46; In the VCEs with complete SB visualisation&#44; there was a higher percentage with excellent&#47;good preparation than fair&#47;poor preparation &#40;93&#46;6&#37; vs 73&#46;4&#37;&#41;&#44; and this difference was significant &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;3&#59; 95&#37; CI&#58; 2&#46;9&#8211;9&#46;5&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#60;0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Of the total VCE studies performed&#44; 349 &#40;18&#46;5&#37;&#41; were on hospitalised patients and 1&#44;534 &#40;81&#46;5&#37;&#41; were carried out on an outpatient basis&#46; Of the in-hospital VCEs&#44; 329 &#40;94&#46;3&#37;&#41; were complete and 20 &#40;5&#46;7&#37;&#41; were incomplete&#46; Among the outpatient VCEs&#44; 1&#44;490 &#40;97&#46;1&#37;&#41; were complete and 44 &#40;2&#46;9&#37;&#41; incomplete&#46; Outpatient VCEs had a higher rate of complete SB visualisation than in-hospital VCEs &#40;97&#46;1&#37; vs 94&#46;3&#37;&#41;&#44; and this difference was significant &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;1&#59; 95&#37; CI 1&#46;2&#8211;3&#46;5&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">There were complications in 58 &#40;3&#46;1&#37;&#41; of the procedures&#46; Bronchoaspiration occurred in eight patients &#40;0&#46;4&#37;&#41;&#59; in three of them the VCE had to be extracted by bronchoscopy&#44; but the other individuals expelled it spontaneously&#46; In 37 &#40;2&#46;0&#37;&#41; of the procedures&#44; VCE retention in the stomach occurred&#44; with all having to have the capsule moved on endoscopically&#46; In 13 cases &#40;0&#46;7&#37;&#41;&#44; the VCE was retained in the SB for more than 15 days&#59; the patients were monitored and in all of them the capsule passed to the colon spontaneously&#46; There were no significant differences in terms of the indication for VCE and the rate of retention in SB &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;076&#41;&#46; Of the 1&#44;047 patients who went on to have treatment after the VCE&#44; that treatment was medical in 931 &#40;88&#46;9&#37;&#41; and endoscopic in 104 &#40;9&#46;9&#37;&#41;&#44; with the remaining 12 &#40;1&#46;2&#37;&#41; having surgical procedures with SB resection &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">In this registry&#44; 1&#44;883 VCEs were analysed&#44; for which the most common indication was suspected SBB &#40;64&#46;4&#37;&#41;&#44; followed by investigation of CD &#40;15&#46;2&#37;&#41;&#44; chronic diarrhoea &#40;11&#46;2&#37;&#41; and abdominal pain &#40;5&#46;2&#37;&#41;&#46; In a systematic review that included 227 publications on VCE&#44; with more than 22&#44;840 patients&#44; the most common indication was OGIB &#40;66&#46;0&#37;&#41;&#44; according to the previously used classification&#44; followed by investigation of CD &#40;10&#46;4&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In a more recent Korean national registry&#44; the most common indication was also OGIB &#40;64&#46;4&#37;&#41;&#44; this time followed by abdominal pain &#40;15&#46;7&#37;&#41; and investigation of CD &#40;only 4&#46;6&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> In a European multicentre study with 733 procedures&#44; the most common indication was OGIB &#40;55&#46;4&#37;&#41;&#44; followed by diarrhoea &#40;15&#46;6&#37;&#41;&#44; abdominal pain &#40;14&#46;7&#37;&#41; and investigation of CD &#40;4&#46;9&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Our data are in line with those reported in the universal literature&#44; with a slightly higher rate of VCE requested for investigation of CD&#44; but this may be due to the participation in our registry of institutions which are national referral centres for the management of CD&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Debate continues to surround the use of bowel preparation for VCE&#46; In this registry&#44; preparation with laxatives&#44; mainly polyethylene glycol&#44; was prescribed in 54&#46;3&#37; of cases&#44; and those who were prepared had better quality of mucosa visualisation compared to those simply prescribed liquid diet the day before&#46; This difference was significant&#46; In contrast to other studies&#44; we also found a significant association between excellent&#47;good quality preparation and higher rates of lesion detection and complete SB visualisation&#46; A meta-analysis with 12 studies found greater diagnostic yield in patients who received preparation with laxatives compared to those simply prescribed clear liquids the day before the study&#44; but did not demonstrate a higher rate of complete SB visualisation&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> A second more recent meta-analysis with 40 studies did not find significant differences in diagnostic yield or in the rate of complete SB visualisation&#44; but they did demonstrate better visualisation quality in examinations with laxative preparation&#44; compared to those prepared with only a clear liquid diet&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Of the total of 1&#44;883 VCEs carried out&#44; no lesions were found in 24&#46;5&#37;&#44; a rate similar to that found in other series&#46; In the Korean study mentioned above<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> 36&#46;2&#37; of studies were found to be negative&#44; and in 260 studies at the Mayo Clinic &#40;Arizona&#44; USA&#41;&#44; 24&#37; were normal&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> In our study&#44; of the total VCEs performed&#44; the most common lesions detected were erosions&#47;ulcers &#40;31&#46;6&#37;&#41; and angioectasias &#40;25&#46;7&#37;&#41;&#46; The Korean national registry found angioectasias in only 9&#46;7&#37; of the VCEs performed and erosions&#47;ulcers in 18&#46;3&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> In 260 VCEs with the sole indication of suspected OGIB&#44; the previously cited Mayo Clinic study<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> found SB angioectasias and ulcers in 61&#37; and 17&#37;&#44; respectively&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In our registry&#44; a high lesion detection rate &#40;75&#46;9&#37;&#41; was found in patients with suspected SBB&#46; However&#44; it is important to establish the clinical relevance of the lesions found&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> To do so&#44; we used the previously discussed Saurin classification &#40;P0&#44; P1&#44; P2&#41;&#44; specifically designed for that purpose and to measure the diagnostic yield&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Regarding the relevance of the lesions found&#44; for the suspected indication of SBB in our registry&#44; the diagnostic yield was 60&#46;6&#37;&#46; VCE yield was higher in patients with suspected overt SBB than suspected occult SBB &#40;66&#46;0&#37; vs 56&#46;0&#37;&#41;&#46; In the original study by Saurin&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> they found a diagnostic yield of 67&#46;2&#37; in patients with OGIB&#46; In the previously mentioned systematic review&#44; the detection rate in OGIB was 60&#46;5&#37;&#44; very similar to that reported in our registry&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> A systematic review of 24 VCE studies in patients with IDA found a diagnostic yield of 47&#37;&#44; with the most common lesions detected being vascular &#40;31&#37;&#41; and inflammatory &#40;17&#46;8&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> These figures are slightly lower than the diagnostic yield for occult SBB in our study&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The complete SB visualisation rate in our national registry was 96&#46;6&#37; and the SB capsule retention rate was 0&#46;7&#37;&#46; We found no significant differences between the type of indication for VCE and the retention rate&#46; A European multicentre study of 733 VCEs found a complete visualisation rate of 85&#46;1&#37; and a retention rate of 1&#46;9&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> A study at the Mayo Clinic in Arizona of 260 VCEs found a complete visualisation rate of 76&#37; and retention rate also of 1&#46;9&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> A Swedish study including 2&#44;300 VCEs found a complete visualisation rate of 80&#37; and capsule retention in 1&#46;3&#37;&#44; with this being more common in patients with CD and tumours&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> In a recent Korean study&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> out of 2&#44;705 VCEs&#44; they found a retention rate of 0&#46;7&#37;&#44; the same figure as in our registry&#46; A systematic review mentioned earlier found a complete SB visualisation rate of 83&#46;5&#37; and a retention rate of 1&#46;4&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> A more recent meta-analysis found a capsule retention rate of 2&#46;1&#37; in VCE for suspected SBB&#44; and 3&#46;6&#37; in procedures for suspected small bowel CD&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> The above differences may be explained by the fact that our VCE procedures were more recent&#44; the majority during this decade&#44; and at all our centres we are able to track the movement of the capsule in real time&#44; so we know when it passes into the duodenum&#46; Also&#44; the outpatient stays in the hospital or clinic until we verify that the capsule has progressed to the SB&#44; and if it remains in the stomach for more than two hours&#44; we move it on to the duodenum endoscopically&#44; which increases the SB visualisation rate&#46; Moreover&#44; the newer VCE models have a longer battery life&#44; increasing the potential duration of the examination&#44; and allowing more time for the capsule to reach the caecum&#46; This was demonstrated in the Korean national registry where&#44; in 4&#44;650 VCE procedures&#44; the incomplete visualisation rate was 16&#37; overall&#44; with a retention rate of 3&#37;&#44; but they found a lower rate of incomplete visualisation in those performed from 2014 to 2019 compared to those from 2002 to 2014 &#40;9&#46;4&#37; vs 18&#46;9&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The retention rate in our registry is very low in comparison with other studies&#46; In Colombia&#44; we have had magnetic resonance enterography available for several years now for assessment of patients with obstructive bowel symptoms&#46; This allows detection of the presence of strictures in a high percentage of cases&#44; which would then contraindicate the use of VCE&#44; thereby reducing the risk of retention&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In our study&#44; outpatient VCE had a higher rate of complete SB visualisation than VCE in hospitalised patients &#40;97&#46;1&#37; vs 94&#46;3&#37;&#41;&#44; with this difference being significant&#46; A study in Chicago &#40;USA&#41; comparing outpatient with in-hospital VCE&#44; found that 90&#46;5&#37; vs 69&#46;6&#37; of the procedures respectively reached the caecum&#44; this difference also being significant &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> This may be explained by hospitalised patients being acutely ill&#44; receiving medications and having more restricted mobility compared to outpatients&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The main limitation of our study is that it was cross-sectional and was therefore susceptible to selection bias&#46; Also&#44; being a multicentre study&#44; the interpretation of the type of lesions may vary according to the criteria used by the different interpreters of VCE lesions at each centre&#46; International expert consensus was recently reached on nomenclature for vascular and inflammatory lesions&#44; and this will hopefully lead to better description of the lesions and greater interobserver agreement among VCE readers&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#44;28</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">The results of this national registry &#40;in brackets&#41; comply with quality measures recently proposed by the European Society for Gastrointestinal Endoscopy&#44; such as a lesion detection rate &#62;50&#37; &#40;75&#46;5&#37;&#41;&#44; a caecum visualisation rate &#62;80&#37; &#40;96&#46;6&#37;&#41; and a capsule retention rate &#60;2&#37; &#40;0&#46;7&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusions</span><p id="par0165" class="elsevierStylePara elsevierViewall">In this Colombian registry&#44; 1&#44;883 VCE procedures were analysed&#44; making it the largest national VCE registry in Latin America&#46; The indications&#44; findings and diagnostic yield of VCE in Colombia are similar to those reported in the universal literature&#44; with a slightly higher rate of VCE requested for investigation of CD compared to other studies for the reasons already mentioned&#46; In addition&#44; 2&#46;7&#37; of the VCEs in our registry had findings of parasites&#44; which is very rarely reported in studies from developed countries&#46; We also found a high percentage of studies with visualisation of the caecum and a low rate of complications&#46; VCEs performed with preparation prior to the procedure showed better quality of SB mucosa cleansing&#44; and this was associated with more detection of SB lesions and a higher rate of complete studies&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Our study provides valuable information on the study of SB disease with VCE in clinical practice in Latin America&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Authors&#47;contributors</span><p id="par0175" class="elsevierStylePara elsevierViewall">F&#46; Juliao-Ba&#241;os&#58; study design&#44; data acquisition and writing of the manuscript&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">M&#46;T&#46; Galiano&#58; data acquisition and review of the manuscript&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">J&#46; Camargo&#58; data acquisition and review of the manuscript&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">G&#46; Mosquera-Klinger G&#58; data acquisition and review of the manuscript&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">J&#46; Carvajal&#44; C&#46; Jaramillo&#44; L&#46;C&#46; Sabbagh&#44; H&#46; Cure&#44; F&#46; Garc&#237;a&#44; B&#46; Velasco&#44; C&#46; Manrique&#44; V&#46; Parra and C&#46; Fl&#243;rez&#58; data acquisition&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">J&#46; Bare&#241;o&#58; statistical analysis and review of the manuscript&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicts of interest</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The small bowel capsule endoscopy &#40;SBCE&#41; has revolutionised the study of small bowel &#40;SB&#41; diseases&#46; The objective of this study is to determine the indications&#44; findings and diagnostic yield of SBCE in a national registry&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">An observational&#44; analytical cross-sectional study was carried out&#44; analysing the SBCE records at seven centres in the country&#44; where different variables were collected&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">1&#44;883 SBCEs were evaluated&#46; The average age was 55&#46;4 years &#40;5&#46;6&#8211;94&#46;2&#41;&#46; The most frequent indications were suspicion of small bowel bleeding &#40;SBB&#41; &#40;64&#46;4&#37;&#41;&#44; study of Crohn&#8217;s disease &#40;15&#46;2&#37;&#41; and chronic diarrhoea &#40;11&#46;2&#37;&#41;&#46; 54&#46;3&#37; were prepared with laxatives&#46; The most frequent lesions found were erosions&#47;ulcers &#40;31&#46;6&#37;&#41;&#44; angioectasias &#40;25&#46;7&#37;&#41; and parasitosis &#40;2&#46;7&#37;&#41;&#46; The diagnostic yield &#40;P1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>P2&#44; Saurin classification&#41; of SBCE in SBB was 60&#46;6&#37;&#44; being higher in overt SBB &#40;66&#46;0&#37;&#41; compared to occult SBB &#40;56&#46;0&#37;&#41; &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#46; The studies with better preparation showed higher detection of lesions &#40;93&#46;8&#37; <span class="elsevierStyleItalic">vs</span>&#46; 89&#46;4&#37;&#41; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;8&#44; CI&#58; 95&#37;&#58; 1&#46;2&#8211;2&#46;6&#59; P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#46; The SBCE complication rate was 3&#46;1&#37;&#44; with complete SB visualisation at 96&#46;6&#37; and SB retention rate of 0&#46;7&#37;&#46; 81&#46;5&#37; of SBCEs were performed on an outpatient basis&#44; and presented a greater complete SB visualisation than hospital ones &#40;97&#46;1&#37; <span class="elsevierStyleItalic">vs&#46;</span> 94&#46;3&#37;&#41; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;1&#44; CI&#58; 95&#37;&#44; 1&#46;2&#8211;3&#46;5&#59; P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The indications&#44; findings and diagnostic performance of SBCEs in Colombia are similar to those reported in the literature&#44; with a high percentage of complete studies and a low rate of complications&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">La video c&#225;psula endosc&#243;pica &#40;VCE&#41; ha revolucionado el estudio de las patolog&#237;as de intestino delgado &#40;ID&#41;&#46; El objetivo de este estudio es determinar las indicaciones&#44; hallazgos y rendimiento diagn&#243;stico de la VCE en un registro nacional&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todos</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio observacional&#44; de corte transversal anal&#237;tico&#44; analizando los registros de VCE en siete centros del pa&#237;s&#44; se recolectaron diferentes variables&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Se evaluaron 1&#46;883 estudios de VCE&#46; La edad promedio fue 55&#46;4 a&#241;os &#40;5&#46;6&#8211;94&#46;2&#41;&#46; Las indicaciones m&#225;s frecuentes fueron sospecha de sangrado de intestino delgado &#40;SID&#41; &#40;64&#46;4&#37;&#41;&#44; estudio enfermedad de Crohn &#40;15&#46;2&#37;&#41; y diarrea cr&#243;nica &#40;11&#46;2&#37;&#41;&#46; 54&#46;3&#37; de VCE se prepararon con laxantes&#46; Las lesiones m&#225;s frecuentes fueron erosiones&#47;&#250;lceras &#40;31&#46;6&#37;&#41;&#44; angiectasias &#40;25&#46;7&#37;&#41; y parasitosis &#40;2&#46;7&#37;&#41;&#46; El rendimiento diagn&#243;stico &#40;P1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>P2&#44; clasificaci&#243;n de Saurin&#41; de VCE en SID fue 60&#46;6&#37;&#44; siendo mayor en SID evidente &#40;66&#46;0&#37;&#41; comparado con SID oculto &#40;56&#46;0&#37;&#41; &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#46; Los estudios con mejor preparaci&#243;n presentaban mayor detecci&#243;n de lesiones &#40;93&#46;8&#37; <span class="elsevierStyleItalic">vs</span> 89&#46;4&#37;&#41; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;8&#44; IC&#58; 95&#37;&#58; 1&#46;2&#8211;2&#46;6&#59; P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#46; La tasa de complicaci&#243;n de VCE fue 3&#46;1&#37;&#44; con visualizaci&#243;n completa del ID en 96&#46;6&#37; y tasa de retenci&#243;n en ID de 0&#46;7&#37;&#46; 81&#46;5&#37; de VCE se realizaron en forma ambulatoria&#44; y presentaron mayor visualizaci&#243;n completa de ID que las hospitalarias &#40;97&#46;1&#37; <span class="elsevierStyleItalic">vs</span> 94&#46;3&#37;&#41; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;1&#44; IC&#58; 95&#37;&#44; 1&#46;2&#8211;3&#46;5&#59; P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Las indicaciones&#44; hallazgos y rendimiento diagn&#243;stico de VCE en Colombia son similares a los reportados en la literatura universal&#44; con alto porcentaje de estudios completos y baja tasa de complicaciones&#46;</p></span>"
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            "identificador" => "abst0040"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Juliao-Ba&#241;os F&#44; Galiano MT&#44; Camargo J&#44; Mosquera-Klinger G&#44; Carvajal J&#44; Jaramillo C&#44; et al&#46; Utilidad cl&#237;nica de la videoc&#225;psula endosc&#243;pica en el estudio de patolog&#237;as de intestino delgado en Colombia&#58; resultados de un registro nacional&#46; Gastroenterol Hepatol&#46; 2021&#59;44&#58;346&#8211;354&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Type of VCE lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">N&#58; 1&#44;883&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Erosions&#47;ulcers</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">595 &#40;31&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Angioectasias</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">484 &#40;25&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Active bleeding with no lesion</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Old bleeding with no lesion</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Lymphangiectasia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Parasites</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hookworm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ascaris&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Whipworm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tapeworm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Strongyloides&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Masses&#47;tumours</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lipoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stromal tumour &#40;GIST&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Carcinoid tumour&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intestinal lymphoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Metastasis of ovarian cancer to ileum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">41 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">42 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Xanthoma</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">5 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Portal hypertensive enteropathy</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;0&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">None</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">462 &#40;24&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders&#58; European Society of Gastrointestinal Endoscopy &#40;ESGE&#41; Clinical Guideline"
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Article information
ISSN: 24443824
Original language: English
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es en pt

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