Spiral enteroscopy: prospective U.S. multicenter study in patients with small-bowel disorders.
BACKGROUND
The performance characteristics of spiral enteroscopy have not been well-described.


OBJECTIVE
To determine the technical performance, diagnostic and therapeutic yields, and safety of oral spiral enteroscopy in patients with suspected or established small-bowel pathology.


METHODS
Prospective, multicenter, cohort study, with centralized database.


METHODS
Ten U.S. tertiary-care medical centers.


METHODS
This study involved 148 participants, of whom 101 were referred for obscure bleeding. All participants referred for antegrade deep enteroscopy were considered eligible.


METHODS
Spiral enteroscopy.


METHODS
Examination duration, depth of insertion, spiral enteroscopy findings, mucosal assessment upon withdrawal, and patient symptom assessment (day 1 and day 7 after the procedure).


RESULTS
Spiral enteroscopy was successful in 93% of patients, with a median depth of insertion beyond the angle of Treitz of 250 cm (range 10-600 cm). The mean (± standard deviation) total procedure time was 45.0 ± 16.2 minutes for all procedures, and 35.4 minutes for diagnostic procedures. The diagnostic yield was 65%, of which 48% revealed more than one abnormality. The most common findings were angiectasias (61.5%), inflammation (7.5%), and neoplasia (6.8%). Argon plasma coagulation ablation accounted for 64% of therapeutic interventions.


CONCLUSIONS
This was not a randomized, controlled trial of deep enteroscopy modalities.


CONCLUSIONS
Spiral enteroscopy appears to be safe and effective for evaluation of the small bowel. The procedure duration, depth of insertion, and diagnostic and therapeutic yields compare favorably with previously published data on other deep enteroscopy techniques such as single-balloon and double-balloon enteroscopy. Comparative studies are warranted.
Morgan
Douglas
D
University of North Carolina, Chapel Hill, North Carolina 27599-7080, USA.
Upchurch
Bennie
B
Draganov
Peter
P
Binmoeller
Kenneth F
KF
Haluszka
Oleh
O
Jonnalagadda
Sreeni
S
Okolo
Patrick
P
Grimm
Ian
I
Judah
Joel
J
Tokar
Jeff
J
Chiorean
Michael
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000628:therapy*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014481:United States; D055815:Young Adult