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Capsule endoscopy and single-balloon enteroscopy in small bowel diseases: Competing or complementary?

World Journal of Gastroenterology 2016年第48期22卷 10625-10630页

作者： Jing-Jing Ma Ying Wang Xiao-Min Xu Jie-Wen Su Wen-Yu Jiang Jian-Xia Jiang Lin Lin Dao-Quan Zhang Jing Ding Li Chen Ting Jiang Ying-Hong Xu Gui Tao Hong-Jie Zhang Department of Gastroenterology The First Affiliated Hospital of Nanjing Medical University Department of Gastroenterology Jiangsu Provincial Hospital

AIM To evaluate diagnostic yields of capsule endoscopy(CE) and/or single-balloon enteroscopy(SBE) in patients with suspected small bowel *** Were trospectively analyzed 700 patients with suspected small bowel diseases from September 2010 to March 2016. CE, SBE, or SBE with prior CE was performed in 401, 353, and 47 patients, respectively. Data from clinical and endoscopy records were collected for analysis. Indications, procedure times, diagnostic yields, and complications were summarized and *** The overall diagnostic yield for the CE group was 57.6%. The diagnostic yield of CE in patients with obscure gastroin testinal bleeding(OGIB) was significantly greater than that in patients with no bleeding(70.5% vs 43.8%, P < 0.01). The overall diagnostic yield of SBE was 69.7%. There was no difference in the diagnostic yield of SBE between patients with OGIB and those with no bleeding(72.5% vs 68.9%, P = 0.534). Forty-seven patients underwent CE prior to SBE. Among them, the diagnostic yield of SBE with positive findings on prior CE was 93.3%. In addition, SBE detected two cases with superficial ulcer and erosive lesions in the small bowel, which were missed by CE. However, one case with lymphoma and two with Crohn's disease were not confirmed by SBE. The rate of capsule retention was 2.0%. There were no significant complications during or after SBE *** SBE is a safe and effective technique for diagnosing small bowel diseases. SBE with prior CE seemed to improve the diagnostic yield of small bowel diseases.

关键词： Capsule endoscopy Small bowel diseases single-balloon enteroscopy Diagnosis balloon-assisted enteroscopy

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single-balloon and spiral enteroscopy may have similar diagnostic and therapeutic yields to double-balloon enteroscopy:Results from a meta-analysis of randomized controlled trials and prospective studies

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World Journal of Meta-Analysis 2020年第2期8卷 153-162页

作者： Yong Gu Xin Shi Yan Yang Xiao-Fei Ye Qiong Wu Zhi-Ping Yang Shui-Xiang He Department of Gastroenterology The First Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710061Shaanxi ProvinceChina Department of Digestive System Diseases Shaanxi Provincial Crops Hospital of Chinese People's Armed Police ForceXi'an 710054Shaanxi ProvinceChina State Key Laboratory of Cancer Biology National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive DiseasesFourth Military Medical UniversityXi'an 710032Shaanxi ProvinceChina Department of Health Statistics Second Military Medical UniversityShanghai 200433China

BACKGROUND Double-balloon,single-balloon,and spiral enteroscopy(DBE,SBE,and SE)have revolutionized the management of intestinal ***,evidence about efficacies of these methods is *** aimed to conduct a meta-analysis comparing the clinical outcomes among DBE,SBE,and *** We searched randomized controlled trials and prospective studies in MEDLINE,PubMed,EMBASE,Cochrane Library,and Chinese CQVIP *** referencing the comparison of at least two of these three methods were *** outcome was diagnostic *** outcomes were therapeutic yield,total enteroscopy,examination time,time to maximum insertion,and depth of maximal insertion(DMI).RESULTS Eleven studies including 727 patients were identified:DBE vs SE(n=6),DBE vs SBE(n=4),and SBE vs SE(n=1).The diagnostic and therapeutic yields did not differ significantly when comparing DBE with SE[odds ratio(OR)=1.19,95%confidence interval(CI):0.68-2.08;OR=1.17,95%CI:0.61-2.23]and DBE with SBE(OR=0.85,95%CI:0.55-1.33;OR=1.71,95%CI:0.64-4.60).Total enteroscopy,examination time,time to maximum insertion,and DMI were similar between SBE and *** was superior to SE with regard to DMI[mean difference(MD)=36.76,95%CI:5.09-68.43],with longer time to maximum insertion(MD=15.14,95%CI:12-18.27)and examination time(MD=12.98,95%CI:9.57-16.38).CONCLUSION DBE and SBE have similar clinical *** with DBE,SE seems to have similar diagnostic and therapeutic yields,but shorter procedural time in cost of less depth of *** needs further evaluation vs *** is recommended for complete enteroscopy.

关键词： Double-balloon enteroscopy single-balloon enteroscopy Spiral enteroscopy Meta-analysis Randomized controlled trials

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Performance characteristics of retrograde single-balloon endoscopy: A single center experience

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World Journal of Gastrointestinal Endoscopy 2016年第15期8卷 501-507页

作者： Kaci E Christian Karan Kapoor Eric M Goldberg Department of Medicine Division of Gastroenterology University of Maryland Medical Center

AIM: To evaluate the technical success, diagnostic yield(DY) and therapeutic potential of retrograde single balloon enteroscopy(rS BE). METHODS: A retrospective review of 136 rS BE procedures performed at a tertiary academic referral center from January 2006 and September 2013 was completed. Patient characteristics including age, gender and inpatient status were collected. The indication for the procedure was categorized into one of three groups: Obscure gastrointestinal bleeding(GIB), evaluation for Crohn's disease and abnormal imaging. Procedural characteristics including insertion depth(ID), procedure time, concordance with pre-procedural imaging and complications were also recorded. Lastly, DY, defined as the percentage of cases producing either a definitive diagnosis or findings that could explain clinical symptoms and therapeutic yield(TY), defined as the percentage of cases in which a definitive intervention was performed, were determined. Mucosal tattooing and biopsy alone were not included in the TY. RESULTS: A total of 136 rS BE procedures were identified. Mean patient age was 57.5(± 16.2) years, 67(49.2%) were male, and 110(80.9%) procedures were performed on an outpatient basis. Indications for rS BE included GIB in 55(40.4%), evaluation of inflammatory bowel disease(IBD) in 29(21.3%), and imaging suggestive of pathology other than GIB or IBD in 43(31.6%). Nine(6.6%) rS BEs were performed for other indications. Mean ID was 68.3(± 39.3) cm proximal to the ileocecal valve and mean time to completion was 41.7(± 15.5) min. Overall, 73(53.7%) cases were diagnostic and 25(18.4%) cases were therapeutic in which interventions(argon plasma coagulation, stricture dilatation, polypectomy, etc.) were performed. Pre-procedural imaging was performed in 88(64.7%) patients. Endoscopic concordance of positive imaging findings was seen in 31(35.2%) cases. Follow up data was available in 93(68.4%) patients; 2(2.2%) reported post-procedural abdominal pain within 30 d follow

关键词： Retrograde single-balloon Enteroscopy Endoscopy

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Current status of single-balloon enteroscopy: Insertability and clinical applications

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World Journal of Gastrointestinal Endoscopy 2015年第1期7卷 59-65页

作者： Takuji Kawamura Koji Uno Kiyohito Tanaka Kenjiro Yasuda Department of Gastroenterology Kyoto Second Red Cross HospitalKyoto 602-8026Japan Department of Stress Science Institute of Health BiosciencesTokushima University Graduate SchoolTokushima 770-8503Japan

The single-balloon enteroscopy(SBE) system was launched in 2007, proposed as a simpler method than double-balloon enteroscopy(DBE). Controversy surrounds whether the SBE system has the same insertability as DBE. However, many methods have been proposed to improve the depth of insertion with the SBE system, involving several techniques and endoscopic accessories. SBE is used for investigating not only small bowel diseases, but also diseases of the pancreatobiliary and colonic structures. SBE is a necessary advancement for many endoscopic procedures and applications in modern clinical practice. In our review, we summarized the current literature concerning the insertability of SBE and described the technical aspects of improving the rate of deep insertion in SBE procedures. In addition, the recent applications of SBE to diseases besides those of the small bowel are described.

关键词： single-balloon enteroscopy Double-balloonenteroscopy Small-bowel endoscopy Endoscopicretrograde cholangiopancreatography Endoscopicsubmucosal dissection

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Comparison between double-balloon and single-balloon enteroscopy in therapeutic ERC after Roux-en-Y entero-enteric anastomosis

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World Journal of Gastrointestinal Endoscopy 2010年第9期2卷 314-317页

作者： Tom G Moreels Paul A Pelckmans Division of Gastroenterology and Hepatology Antwerp University Hospital

AIM:To compare the efficacy of double-balloon enteroscopy (DBE) and single-balloon enteroscopy (SBE) in therapeutic endoscopic retrograde cholangiography (ERC) in patients with Roux-en-Y entero-enteric ***:Retrospective analysis of our patient cohort revealed 4 patients with enterobiliary anastomosis and Roux-en-Y entero-enteric anastomosis who underwent repeated ERC with DBE and SBE because of recurrent ***:A total of 38 endoscopic retrograde cholangiopancreatography procedures were performed in 25 patients with Roux-en-Y entero-enteric *** was used in 29 procedures and SBE in *** 4 patients who underwent repeated ERC with DBE and SBE suffered from recurrent cholangitis due to stenosis of the enterobiliary *** was performed repeatedly to achieve balloon dilation with/without biliary stone extraction and multiple stent placement at the level of the enterobiliary *** all 4 patients DBE and SBE were equally *** to DBE,SBE was equally effective in passing the Roux-en-Y entero-enteric anastomosis,reaching the enterobiliary anastomosis and performing therapeutic ***:This retrospective comparison shows that DBE and SBE are equally successful in the performance of therapeutic ERC at the level of the enterobiliary anastomosis after Roux-en-Y entero-enteric anastomosis.

关键词： Roux-en-Y Double-balloon enteroscope single-balloon enteroscope Endoscopic retrograde cholangiopancreatography

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Clinical usefulness of single-balloon endoscopy in patients with previously incomplete colonoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第3期5卷 117-121页

作者： Kiyonori Kobayashi Miyuki Mukae Taishi Ogawa Kaoru Yokoyama Miwa Sada Wasaburo Koizumi Department of Gastroenterology Kitasato University School of MedicineKanagawa 252-0380Japan

AIM:To evaluate the clinical usefulness of singleballoon endoscopy(SBE) in patients in whom a colonoscope was technically difficult to insert ***:The study group comprised 15 patients(8 men and 7 women) who underwent SBE for colonoscopy(30 sessions).The number of SBE sessions was 1 in 7 patients,2 in 5 patients,3 in 1 patient,4 in 1 patient,and 6 in 1 *** all patients,total colonoscopy was previously *** reasons for difficulty in scope passage were an elongated colon in 6 patients,severe intestinal adhesions after open surgery in 4,an elongated colon and severe intestinal adhesions in 2,a left inguinal hernia in 2,and multiple diverticulosis of the sigmoid colon in *** endoscopists were responsible for *** technique for inserting SBE in the colon was basically similar to that in the small *** effectiveness of SBE was assessed on the basis of the success rate of total colonoscopy and the presence or absence of *** also evaluated the diagnostic and treatment outcomes of colonoscopic examinations with ***:Total colonoscopy was successfully accomplished in all *** mean insertion time to the cecum was 22.9 ± 8.9 min(range 9 to 40).Abnormalities were found during 21 sessions of *** most common abnormality was colorectal polyps(20 sessions),followed by radiation colitis(3 sessions) and diverticular disease of the colon(3 sessions).Colorectal polyps were resected endoscopically in 15 sessions.A total of 42 polyps were resected endoscopically,using snare polypectomy in 32 lesions,hot biopsy in 7 lesions,and endoscopic mucosal resection in 3 ***-six colorectal polyps were newly diagnosed on colonoscopic examination with ***,these lesions included 2 intramucosal cancers,42 tubular adenomas,and 2 tubulovillous *** mean examination time was 48.2 ± 20.0 min(range 25 to 90).Colonoscopic examination or endoscopic treatment with SBE was not associated with an

关键词： single-balloon endoscopy Colonoscopy Difficult to insert Diagnosis Endoscopic treatment

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Ileal gallstone obstruction:single-balloon enteroscopic removal

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World Journal of Gastrointestinal Endoscopy 2010年第9期2卷 321-324页

作者： Hauke Sebastian Heinzow Tobias Meister Johannes Wessling Wolfram Domschke Hansjoerg Ullerich Department of Medicine B University of Muenster Department of Radiology University of Muenster

Gallstone-induced ileus is a rare complication of *** localization of gallstones impacted in the small bowel,especially in the ileum,prevents access by conventional endoscopy in most cases,the mainstay of treatment remains *** invention of double-and single-balloon enteroscopy has added much to the ability of imaging the small bowel and enables endoscopically directed ***,for the first time,we report a successful endoscopic calculus removal via peroral single-balloon enteroscopy in an 81-year-old woman suffering from gallstone ileus of the ileum.

关键词： Gallstone ileus Small bowel obstruction single-balloon enteroscopy Cholelithiasis

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Utility of single and double balloon endoscopy in patients with difficult colonoscopy: A randomized controlled trial

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World Journal of Gastroenterology 2013年第29期19卷 4732-4736页

作者： Atsuo Yamada Hirotsugu Watabe Noriyuki Takano Goichi Togo Yutaka Yamaji Haruhiko Yoshida Takao Kawabe Masao Omata Kazuhiko Koike Department of Gastroenterology University of Tokyo Tokyo 113-8655 Japan

AIM: To compare the utility of single-balloon colonoscopy (SBC) or double-balloon colonoscopy (DBC) for difficult colonoscopies. METHODS: Between August 2008 and June 2010, patients in whom total colonoscopy failed within 30 min of insertion were assigned randomly to undergo either SBC or DBC. No sedatives were used. After the endoscopy, all patients were asked to evaluate pain during the procedure on a 10-point analog scale (1 = no pain; 10 = worst imaginable pain) with a questionnaire. The study outcomes were the cecal intubation rate and time, endoscopic findings, complications, and pain score. RESULTS: The SBC and DBC groups included 11 and 10 patients, respectively. All but one SBC patient achieved total colonoscopy successfully. The cecal intubation times were 18 min (range: 10-85 min) and 12.8 min (range: 9.5-42 min) in the SBC and DBC groups, respectively (P= 0.17). No difference was observed in the prevalence of colon polyps between the SBC and DBC groups (45% vs 30%, P = 0.66). SBC showed advanced colon cancer in the ascending colon, which was inaccessible using conventional colonoscopy. The respective pain scores were 5 (1-10) [median (range)] and 5 (1-6) in the SBC and DBC groups (P = 0.64). No complications were noted in any patient. CONCLUSION: The utility of singleand double-balloon endoscopy for colonoscopy seems comparable in patients with incomplete colonoscopy using a conventional colonoscope.

关键词： Difficult colonoscopy Double-balloon endoscopy single-balloon endoscopy Double-balloon colonoscopy single-balloon colonoscopy

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