Endoscopy 2022; 54(12): 1147-1155
DOI: 10.1055/a-1831-6215
Original article

Motorized spiral enteroscopy: results of an international multicenter prospective observational clinical study in patients with normal and altered gastrointestinal anatomy

 1   Department of Internal Medicine and Gastroenterology, Evangelisches Krankenhaus Düsseldorf, Germany
,
Tom Moreels
 2   Department of Gastroenterology and Hepatology, Hospital Department Clinique Universitaires Saint-Luc Université, Brussels, Belgium
,
Marianna Arvanitakis
 3   Department of Gastroenterology and Hepato-Pancreatology, Université Libre des Bruxelles, Erasme Hospital, Brussels, Belgium
,
Mathieu Pioche
 4   Department of Digestive Diseases, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France
,
Jean-Christophe Saurin
 4   Department of Digestive Diseases, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France
,
Andrea May
 5   Department of Internal Medicine II, Sana Klinikum Offenbach GmbH, Offenbach, Germany
 6   Department of Gastroenterology, Asklepios Paulinen Klinik, Wiesbaden, Germany
,
Mate Knabe
 5   Department of Internal Medicine II, Sana Klinikum Offenbach GmbH, Offenbach, Germany
 7   Department of Gastroenterology and Hepatology, Center of Internal Medicine, Hospital of the Goethe University Frankfurt, Frankfurt am Main, Germany
,
Jørgen Steen Agnholt
 8   Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
,
Niels Christian Bjerregaard
 8   Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
,
Lauri Puustinen
 9   Division of Gastroenterology, Helsinki University Central Hospital, Helsinki, Finland
,
Christoph Schlag
10   Department of Internal Medicine II, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
11   Department of Gastroenterology and Endoscopy, Universitätsspital Zürich, Zurich, Switzerland
,
Lars Aabakken
12   Institute of Clinical Medicine, OUS-Rikshospitalet University Hospital, Oslo, Norway
,
Vemund Paulsen
12   Institute of Clinical Medicine, OUS-Rikshospitalet University Hospital, Oslo, Norway
,
Markus Schneider
 1   Department of Internal Medicine and Gastroenterology, Evangelisches Krankenhaus Düsseldorf, Germany
,
Markus F. Neurath
13   Department of Internal Medicine I for Gastroenterology, Pulmonology and Endocrinology, University Hospital Erlangen, Erlangen, Germany
,
Timo Rath
13   Department of Internal Medicine I for Gastroenterology, Pulmonology and Endocrinology, University Hospital Erlangen, Erlangen, Germany
,
Jacques Devière
 3   Department of Gastroenterology and Hepato-Pancreatology, Université Libre des Bruxelles, Erasme Hospital, Brussels, Belgium
,
Horst Neuhaus
 1   Department of Internal Medicine and Gastroenterology, Evangelisches Krankenhaus Düsseldorf, Germany
› Author Affiliations
Olympus

Trial Registration: ClinicalTrials.gov Registration number (trial ID): NCT03955081 Type of study: Prospective multicenter observational study

Abstract

Background Motorized spiral enteroscopy (MSE) has been shown to be safe and effective for deep enteroscopy in studies performed at expert centers with limited numbers of patients without previous abdominal surgery. This study aimed to investigate the safety, efficacy, and learning curve associated with MSE in a real-life scenario, with the inclusion of patients after abdominal surgery and with altered anatomy.

Methods Patients with indications for deep enteroscopy were enrolled in a prospective observational multicenter study. The primary objective was the serious adverse event (SAE) rate; secondary objectives were the diagnostic and therapeutic yield, procedural success, time, and insertion depth. Data analysis was subdivided into training and core (post-training) study phases at centers with different levels of MSE experience.

Results 298 patients (120 women; median age 68, range 19–92) were enrolled. In the post-training phase, 21.5 % (n = 54) had previous abdominal surgery, 10.0 % (n = 25) had surgically altered anatomy. Overall, SAEs occurred in 2.3 % (7/298; 95 %CI 0.9 %–4.8 %). The SAE rate was 2.0 % (5/251) in the core group and 4.3 % (2/47) in the training group, and was not increased after abdominal surgery (1.9 %). Total enteroscopy was achieved in half of the patients (n = 42) undergoing planned total enteroscopy. In 295/337 procedures (87.5 %), the anatomical region of interest could be reached.

Conclusions This prospective multicenter study showed that MSE was feasible and safe in a large cohort of patients in a real-life setting, after a short learning curve. MSE was shown to be feasible in postsurgical patients, including those with altered anatomy, without an increase in the SAE rate.

Supplementary material



Publication History

Received: 16 October 2021

Accepted after revision: 21 April 2022

Accepted Manuscript online:
21 April 2022

Article published online:
23 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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