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Background and study aims  Colon capsule endoscopy (CCE) has been proposed as an alternative to colonoscopy for screening patients at average risk of colorectal cancer (CRC). A prospective national cohort was developed to assess relevance of CCE in real-life practice and its short- and long-term impacts on clinical management. Patients and methods  All patients who underwent a CCE in France were prospectively enrolled from January 2011 to May 2016 and reached annually by phone until May 2017. All CCE and colonoscopy reports were systematically collected. Results  During the study period, 689 CCEs were analyzed from 14 medical centers. Median follow-up time was 35 months [IQR: 12-50]. Indication for CCE was mainly for elderly patients (median age: 70 years, IQR: [61-79]) due to anesthetic or colonoscopy contraindication (n = 307; 44.6 %). Only 337 CCEs (48.9 %) were both complete and with adequate bowel preparation. Advanced neoplasia (adenoma with high-grade dysplasia or CRC) was diagnosed following 32 CCEs (4.6 %). Among patients who underwent colonoscopy or therapeutic surgery following CCE, 18.8 % of all advanced neoplasias (6/32) had not been diagnosed by CCE mainly due to technical issues. Performing a colonoscopy in the case of significant polyps or insufficient bowel cleansing or after an incomplete CCE allowed the diagnosis of 96.9 % of all identified advanced neoplasias (31/32). Conclusions  Outside the scope of academic trials, improvement is needed to increase the reliability of CCE as less than half were considered optimal i. e. complete with adequate bowel cleansing. Most of missed colonic advanced neoplasia were due to incomplete CCE with distal neoplasia location., Competing Interests: Competing interests Dr. Benech has received a travel grant from Maat. R. Benzmouzig has received research support from Medtronic, is a consultant for Medtronic and Alfasigma, has taught for Medtronic and Mayoly Spindler, and received a Congress invitation from Mayoly Spindler. Dr. Ponchon has taught for Olympus. Dr. Dray has received research support from MSD and Norgine, done consulting for Medtronic and Boston Scientific, taught for Fujifilm, Medtronic, Alfasigma, and Bouchara-Recordati, received a Congress invitation from AbbVie, Biocodex, Boston Scientific, Hospira (groupe Pfizer), and MSD, and is a cofounder of and shareholder in Augmented Endoscopy. Dr. Sacher-Huvelin has done consulting for Medtronic. Dr. Galmiche has done consulting for Medtronic and Fujifilm. Dr. Saurin has done consulting for AbbVie, Bouchara-Recordati, Mayoly Spindler, Medtronic, ABS-Bolton, and Intromedic and received a Congress invitation from AbbVie, MSD, and Hospira (groupe Pfizer). This study was funded by Medtronic, which provided CCE, funds for e-CRF constitution, and salary for a clinical research assistant that reviewed all CCE, colonoscopy reports, and performed the follow-up., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Background and study aims  Over-the-scope clip (OTSC) has been recently used in management of gastrointestinal perforations, but data on it are still limited. The aim of this study was to compare management of iatrogenic perforations before and after the OTSC was available in our endoscopy unit. Patients and methods  We conducted a monocentric retrospective study from June 2007 to June 2015. All iatrogenic gastrointestinal perforations detected during endoscopy were included. Two time periods were compared in terms of surgery and mortality rates: before use of OTSC (June 2007 to June 2011) and after OTSC became available (June 2011 to June 2015). Results  During the first period, 24 perforations were recorded. Fifteen (62.5 %) were managed with surgery. The mortality rate was 8 %. During the second period, 16 perforations occurred. In 11 patients (68.7 %), an OTSC was used to close the perforation, with complete sealing of the perforation in 100 % of cases. However, 2 patients with sigmoid perforation had to undergo surgery due to right ureteral obstruction by the clip in 1 case and to presence of a localized peritonitis in the other. The surgery rate during this period was 12.5 % (2 /16), with a statistically significant difference compared to the first period ( P  = 0.002). There was no mortality in the second period versus 8 % in the first one ( P  = 0.23). Conclusions  OTSC is effective for endoluminal closure of iatrogenic perforations and results in a significant decrease in surgery rate.