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Single-balloon enteroscopy: results from an initial experience at a U.S. tertiary-care center - 24/08/11

Doi : 10.1016/j.gie.2010.03.1117 
David J. Frantz, MD, MS, Evan S. Dellon, MD, MPH, Ian S. Grimm, MD, Douglas R. Morgan, MD, MPH
Current affiliations: Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA 

Reprint requests: Douglas R. Morgan, MD, MPH, CB#7080, Bioinformatics Building, 130 Mason Farm Road, UNC-CH, Chapel Hill, NC 27599-7080

Riassunto

Background

Single-balloon enteroscopy (SBE) is a novel, deep-enteroscopy modality for diagnosis and treatment of disorders of the small bowel.

Objective

The aim of the study was to examine the performance, yield, and safety of SBE in the initial experience at a tertiary-care center.

Design

Retrospective analysis of all SBEs during a 10-month period in 2008. Data were extracted from electronic clinical and endoscopy records.

Setting

U.S. tertiary-care center.

Patients

All patients referred to our center for SBE during the study period were included in the current analysis.

Intervention

SBE.

Main Outcome Measurements

Anterograde SBE procedure time, diagnostic yield, and complications.

Results

Thirty-eight anterograde SBEs were performed. The mean patient age was 62 years (42% female). Patients were referred for GI bleeding (97%), Crohn's disease, suspected polyps or neoplasia, and abnormal capsule endoscopy results. The mean (± SD) procedure time was 49 ± 19 minutes. The estimated depth of insertion was proximal jejunum (34%), mid-jejunum (45%), and distal jejunum (21%). The SBE diagnostic yield was 47%, with significant findings in 18 patients. Findings included angiectasias, bleeding, abnormal mucosa, ulceration, polyps, and a foreign body. The therapeutic yield was 42%, with lesion ablation performed in 24% of cases. Diagnostic biopsies were performed in 24% of cases and tattooing in 52%. There were no significant complications.

Limitations

Single-center, retrospective study.

Conclusion

Single-balloon enteroscopy appears to be a safe and efficient method for examination of the mid-small bowel. The significant therapeutic yield (42%) suggests that comparative studies with double-balloon and spiral enteroscopy are warranted.

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Abbreviations : AVM, CE, DBE, SBE


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 DISCLOSURE: E.S. Dellon disclosed receipt of grant funds from Olympus. I.S. Grimm and D.R. Morgan disclosed endoscopy clinical trial support from Spirus Medical. This study was supported in part by grant P30 DK 034987 from the University of North Carolina Center for Gastrointestinal Biology and Disease. All authors disclosed no other financial relationships relevant to this publication.


© 2010  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 72 - N° 2

P. 422-426 - agosto 2010 Ritorno al numero
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