Endoscopy 2022; 54(11): 1034-1042
DOI: 10.1055/a-1783-4802
Original article

The performance and safety of motorized spiral enteroscopy, including in patients with surgically altered gastrointestinal anatomy: a multicenter prospective study

1   Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, The Netherlands
,
Hanneke Beaumont
2   Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location VUMC, Amsterdam, The Netherlands
,
Jan Jacob Koornstra
3   Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
,
Petra van Boeckel
1   Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, The Netherlands
,
Dorien Oude Hergelink
3   Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
,
Jolein van der Kraan
4   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
,
Akin Inderson
4   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
,
Rogier de Ridder
5   Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands
,
Maarten Jacobs
2   Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location VUMC, Amsterdam, The Netherlands
› Author Affiliations
Trial Registration: ClinicalTrials.gov Registration number (trial ID): NCT04884113 Type of study: Prospective Multicenter Study


Abstract

Background Data are scarce on the efficacy and safety of motorized spiral enteroscopy (MSE). No data are available on the utility of this technique in patients with surgically altered gastrointestinal (GI) anatomy. We aimed to evaluate the safety and efficacy of MSE in patients with suspected small-bowel disease, including those with surgically altered GI anatomy.

Methods A multicenter prospective observational, uncontrolled study evaluated MSE in consecutive patients with suspected small-bowel pathology and an indication for diagnostic and/or therapeutic intervention.

Results A total of 170 patients (102 men; median age 64 years, range 18–89) were included. The overall diagnostic yield was 64.1 %. Endotherapy was performed in 53.5 % of procedures. The median total procedure times for the antegrade and retrograde approaches were 45 minutes (interquartile range [IQR] 30–80) and 40 minutes (IQR 30–70), respectively. When total (pan)enteroscopy was intended, this was achieved at rate of 70.3 % (28.1 % by antegrade approach and 42.2 % by a bidirectional approach). Surgically altered GI anatomy was present in 34 /170 of all procedures (20.0 %) and in 11 /45 of the successful total enteroscopy procedures (24.4 %). Propofol sedation or general anesthesia were used in 92.9 % and 7.1 % of the procedures, respectively. Minor adverse events were observed in 15.9 % of patients, but there were no major adverse events.

Conclusion MSE seems to be an effective and safe endoscopic procedure. Total (pan)enteroscopy can be achieved, in one or two sessions, even in the presence of surgically altered GI anatomy. The total procedure time is relatively short. For both antegrade and retrograde MSE procedures, propofol sedation seems sufficient and safe.

Fig. 1 s, Tables 1 s, 2 s



Publication History

Received: 21 October 2021

Accepted after revision: 28 February 2022

Accepted Manuscript online:
28 February 2022

Article published online:
06 May 2022

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