Review Article|Articles in Press

Performance and safety of motorized spiral enteroscopy: a systematic review and meta-analysis

Published:February 02, 2023DOI:
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      Background and Aims

      The introduction of motorized spiral enteroscopy (mSe) into clinical practice holds diagnostic and therapeutic potential for small bowel investigation. This systematic review with meta-analysis aims to evaluate the performance of this modality in diagnosing and treating small bowel lesions.


      A systematic search in Medline and Cochrane databases were performed through September 2022. The primary outcome was diagnostic success, defined as the identification of a lesion relative to the indication. Secondary outcomes included successful therapeutic manipulations, total enteroscopy rate (examination from the duodenojejunal flexion to the cecum), technical success (passage from the ligament of Treitz or ileocecal valve for anterograde and retrograde approach, respectively) and complication rates. We performed meta-analyses using a random effects model and the results were reported as percentages with 95% Confidence Intervals (95%CIs).


      From 2016 to 2022 nine studies [959 patients; 42% females; mean age>45 years; 474 (49.4%) investigated for mid GI bleeding/anemia) were considered eligible and included in analysis. The diagnostic success rate of mSE was 78% (95%CI:72-84; I2=78.3%). Considering secondary outcomes, total enteroscopy was attempted in 460 cases, and completed with a rate of 51% (95%CI:30-72; I2=96.2%), whereas therapeutic interventions were successful in 98% (95%CI:96-100; I2=79.8%) of cases where attempted. Technical success rates were 96% (95%CI:94-97; I2=1.5%) for anterograde and 97% (95%CI:94-100; I2=38.6%) for retrograde approaches, respectively. Finally, the incidence of complications was 17% (95%CI:13-21; I2=65.1%), albeit the vast majority included minor adverse events [16% (95%CI: 11-20; I2=67.2%) vs major= 1% (95%CI:0-1; I2=0%)].


      Motorized spiral enteroscopy provides high rates of diagnostic and therapeutic success with a low prevalence of severe adverse events.



      CI (confidence intervals), DAE (device-assisted enteroscopy), DBE (double balloon enteroscopy), ERCP (endoscopic retrograde cholangio-pancreatography), GI (gastrointestinal), NHLBI (National Heart, Lung, and Blood Institute), mSE (motorized spiral enteroscopy), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), RCTs (randomized controlled trials), SBE (single balloon enteroscopy), SE (spiral endoscopy), VCE (video capsule endoscopy)
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