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Wireless capsule endoscopy in adolescents with familial adenomatous polyposis

Abstract

Aims and background

Guidelines for surveillance in patients with familial adenomatous polyposis (FAP) recommend mutation carriers to undergo periodic colorectal examination starting in the early teens. Performing colonoscopy in children may lead to complications. Wireless capsule endoscopy (WCE) has been introduced recently to evaluate both the upper and lower gastrointestinal tract, and seems suitable as a first screening examination for adolescents. The aim of this study was to evaluate the pros and cons of WCE.

Methods

This was a retrospective review of a single institution database of adolescent patients with FAP identified through the Hereditary Colorectal Tumor Registry between 2007 and 2013. The main outcomes were identification of upper and lower gastrointestinal tract polyps, tolerance of the examination, and number and size of polyps.

Results

Of 46 adolescent patients with FAP, 14 (30.4%) patients carrying adenomatous polyposis coli gene (APC) mutation, 6 male and 8 female, age (median, range) 12 (10-17) years, body mass index 19 (13-24), underwent WCE as first screening examination. The examination was completed in 13 patients (93.3%). Wireless capsule endoscopy identified the duodenal papilla in 4 patients and colonic and rectal polyps in all 13 patients. In 7 patients, fewer than 25 polyps were identified. No complications were recorded related to the use of the video capsule.

Conclusions

Wireless capsule endoscopy is feasible and well-tolerated as a first screening examination in adolescent patients. It cannot be used as alternative to the colonoscopy, but could improve compliance with colonoscopy, and increase early adherence to a surveillance program.

Tumori 2016; 102(1): 40 - 44

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000390

Authors

Debora Cavallo, Giovanni Ballardini, Andrea Ferrari, Gabriele Delconte, Stefano Signoroni, Paola Sala, Stefano Chiaravalli, Maura Massimino, Lucio Bertario, Marco Vitellaro

Article History

Disclosures

Financial support: None.
Conflict of interest: None.
Meeting presentation: The article is based on a previous poster presentation at the meeting of the Collaborative Group of the Americas on Inherited Colorectal Cancer (CGA-ICC), Anaheim, CA, USA, October 2013.

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Authors

Affiliations

  • Colorectal Surgery Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Diagnostic and Surgical Endoscopy Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Pediatric Oncology, Department of Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Hereditary Digestive Tract Tumors Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy

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