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Motorized Spiral Enteroscopy versus Double Balloon Enteroscopy: A Case-Matched Study

Published:October 10, 2022DOI:https://doi.org/10.1016/j.gie.2022.09.030
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      Abstract

      Background and Aims

      Motorized spiral enteroscopy (MSE) has been postulated to ease the complexities of the standard of care double balloon enteroscopy (DBE). However, there are no comparative studies between MSE and DBE. This study aimed to compare the therapeutic outcomes and safety between MSE and DBE.

      Methods

      In this case-matched study, patients were matched 1:2 (MSE/DBE) by age, sex, body mass index (BMI), and American Society of Anesthesiology (ASA) scores. Thirty-one patients who underwent MSE were compared with 62 patients who underwent DBE from 2014 to 2022. Our primary outcomes were to compare the technical and diagnostic success rates between DBE and MSE. Our secondary outcomes were to compare the therapeutic success and complication rates.

      Results

      The main indications of enteroscopy were suspected GI bleeding and positive radiological findings. Prior abdominal surgery was reported in 35.5% and 22.6% of DBE and MSE patients, respectively. Most were antegrade enteroscopy (71%). We found no significant difference in the technical success (DBE 98.4% vs. MSE 96.8%, p=0.62), diagnostic success (DBE 66.1% vs. MSE 54.8%, p=0.25) and the therapeutic success rates (DBE 62.8% vs. MSE 52.9%, p=0.62) between the groups. Complications occurred in one DBE and 11 MSE patients. Most were minor (n=10, 25.6%). Two patients (5.1%) in the MSE group sustained deep lacerations in the proximal esophagus requiring hospitalization. One developed ileal perforation after MSE needing surgical repair.

      Conclusion

      In patients requiring enteroscopy, the diagnostic and therapeutic performance of MSE is similar to DBE. An increased frequency of adverse events was observed with MSE. There are some restriction in the indication because of the design of MSE.

      Abbreviations:

      DAE (device assisted enteroscopy), DBE (double balloon enteroscopy), MSE (motorised spiral enteroscopy), SAE (serious adverse events), BMI (Body mass index), SD (Standard deviation)
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