Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine: preliminary experiences.
OBJECTIVE
As a tool for examining the small intestine, double-balloon enteroscopy (DBE) has been used routinely. However, there remain a few issues relating to the handling of DBE, such as attaching a balloon to the tip of the scope, and inflating/deflating the two balloon systems. Recently, we developed a novel single-balloon enteroscopy (SBE) system for the examination of the small intestine. The aim of the present study was to evaluate the insertion technique, the safety, and the clinical impact of the SBE system.


METHODS
Between January 2006 and June 2007, all patients undergoing enteroscopy with the Olympus SBE system (length 200 cm, outer diameter 9.2 mm) were studied. Instead of a balloon attached to the distal scope end, the distal scope end was hook-shaped, and manipulating the up-angle or down-angle of the scope end enabled exploration of the small intestine.


RESULTS
A total of 78 procedures were performed in 41 patients (24 men, 17 women; mean age 48.9 years, range 23 - 85 years). The indications for the examination were suspected mid-gastrointestinal bleeding (n = 12), Crohn's disease (n = 17), abdominal pain (n = 8), and abdominal tumor (n = 4). The mean procedure time was 62.8 +/- 20.2 minutes and 70.4 +/- 19.3 minutes for the oral and anal routes, respectively. Among 24 patients in whom total enteroscopy was attempted, the entire small intestine was explored in 6.


CONCLUSIONS
SBE is not only easy to perform, due to the single balloon, but it can also safely examine the deep small intestine. Therefore, SBE may be a useful diagnostic and therapeutic tool in addition to DBE for investigating suspected small bowel disease.
Division of Gastroenterology, Shiga University of Medical Science Hospital, Shiga, Japan. tujikawa@belle.shiga-med.ac.jp
T
T
Tsujikawa
Y
Y
Saitoh
A
A
Andoh
H
H
Imaeda
K
K
Hata
H
H
Minematsu
K
K
Senoh
K
K
Hayafuji
A
A
Ogawa
T
T
Nakahara
M
M
Sasaki
Y
Y
Fujiyama
D000008:Abdominal Neoplasms / Q000175:diagnosis / Q000628:therapy; D015746:Abdominal Pain / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003424:Crohn Disease / Q000175:diagnosis / Q000628:therapy; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000628:therapy*; D007421:Intestine, Small; D007564:Japan; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome