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Ameta-analysis on efficacy and safety:single-balloon ***-balloon enteroscopy

Gastroenterology Report 2015年第2期3卷 148-155页

作者： Vaibhav Wadhwa Saurabh Sethi Sumeet Tewani Sushil kumar Garg douglas k.pleskow Ram Chuttani Tyler M.Berzin Nidhi Sethi Mandeep S.Sawhney Department of Internal Medicine Fairview HospitalCleveland ClinicClevelandOHUSA Division of Gastroenterology Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMAUSA Division of Basic and Translational Research Department of SurgeryUniversity of MinnesotaMinneapolisMNUSA

Background and aim:Double-balloon enteroscopy(DBE)and single-balloon enteroscopy(SBE)are new techniques capable of providing deep *** of individual studies comparing these techniques have not been able to identify a superior *** aim was to systematically pool all available studies to compare the efficacy and safety of DBE with SBE for evaluation of the small ***:Databases were searched,including PubMed,Embase,and the Cochrane Central Register of Controlled *** main outcome measures were complete small-bowel visualization,diagnostic yield,therapeutic yield,and complication *** analysis was performed using Review Manager(RevMan version 5.2).Meta-analysis was performed using fixed-effect or random-effect methods,depending on the absence or presence of significant *** used the v2 and I2 test to assess heterogeneity between *** were expressed as risk ratios(RR)or mean differences with 95%confidence intervals(CI).Results:Four prospective,randomized,controlled trials with a total of 375 patients were *** was superior to SBE for visualization of the entire small bowel[pooled RR=0.37(95%CI:0.19–0.73;P=0.004)].DBE and SBE were similar in ability to provide diagnosis[pooled RR=0.95(95%CI:0.77–1.17;P=0.62)].There was no significant difference between DBE and SBE in therapeutic yield[pooled RR=0.78(95%CI:0.59–1.04;P=0.09)]and complication rate[pooled RR=1.08(95%CI:0.28–4.22);P=0.91].Conclusions:DBE was superior to SBE with regard to complete small bowel *** was similar to SBE with regard to diagnostic yield,ability to provide treatment and complication rate,but these results should be interpreted with caution as they is based on very few studies and the overall quality of the evidence was rated as low tomoderate,due to the small sample size.

关键词： small bowel enteroscopy single-balloon enteroscopy double-balloon enteroscopy meta-analysis outcomes

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Multispectral light scattering endoscopic imaging of esophageal precancer

引用

Light(Science & Applications) 2017年第1期6卷 45-54页

作者： Le Qiu Ram Chuttani douglas k pleskow Vladimir Turzhitsky Umar khan Yuri N Zakharov Lei Zhang Tyler M Berzin Eric U Yee Mandeep S Sawhney Yunping Li Edward Vitkin Jeffrey D Goldsmith Irving Itzkan Lev T Perelman Center for Advanced Biomedical Imaging and Photonics Division of GastroenterologyDepartment of MedicineBeth Israel Deaconess Medical CenterHarvard UniversityBostonMA 02215USA Division of Gastroenterology Department of MedicineBeth Israel Deaconess Medical CenterHarvard UniversityBostonMA 02215USA Department of Pathology Beth Israel Deaconess Medical CenterHarvard UniversityBostonMA 02215USA Department of Anesthesia Critical Care and Pain MedicineBeth Israel Deaconess Medical CenterHarvard UniversityBostonMA 02215USA Biological and Biomedical Sciences Program Harvard UniversityBostonMA 02215USA

Esophageal adenocarcinoma is the most rapidly growing cancer in *** the prognosis after diagnosis is unfavorable,the chance of a successful outcome increases tremendously if detected early while the lesion is still ***,the present standard-of-care,endoscopic surveillance,has major limitations,since dysplasia is invisible,often focal,and systematic biopsies typically sample less than one percent of the esophageal lining and therefore easily miss *** solve this problem we developed a multispectral light scattering endoscopic imaging *** surveys the entire esophageal lining and accurately detects subcellular dysplastic *** system combines light scattering spectroscopy,which detects and identifies invisible dysplastic sites by analyzing light scattered from epithelial cells,with rapid scanning of the entire esophageal lining using a collimated broadband light beam delivered by an endoscopically compatible fiber optic *** we report the results of the first comprehensive multispectral imaging study,conducted as part of routine endoscopic procedures performed on patients with suspected *** a double-blind study that characterized the system’s ability to serve as a screening tool,55 out of 57 patients were diagnosed *** addition,a smaller double-blind comparison of the multispectral data in 24 patients with subsequent pathology at locations where 411 biopsies were collected yielded an accuracy of 90%in detecting individual locations of dysplasia,demonstrating the capability of this method to serve as a guide for biopsy.

关键词： biophotonics endoscopic multispectral imaging light scattering spectroscopy noninvasive cancer detection

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