title: Prospective evaluation of the long-term outcomes after deep small-bowel spiral enteroscopy in patients with obscure GI bleeding.
abstract: BACKGROUND
  Spiral enteroscopy can be safe and effective in the short term for evaluation of obscure GI bleeding, but long-term data are lacking.
  
  
  OBJECTIVE
  To assess the long-term clinical outcomes after deep small-bowel spiral enteroscopy performed for obscure GI bleeding.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Academic referral center.
  
  
  METHODS
  This study included 78 patients who underwent antegrade spiral enteroscopy for evaluation of obscure GI bleeding.
  
  
  METHODS
  Diagnostic spiral enteroscopy with hemostatic therapeutic maneuvers applied as indicated.
  
  
  METHODS
  Postprocedure evidence of recurrent overt GI bleeding, blood transfusion requirements, need for iron supplementation, serum hemoglobin values, and the need for additional therapeutic procedures.
  
  
  RESULTS
  Long-term follow-up data (mean [± standard deviation] 25.3 ± 7.5 months; range 12.9-38.8 months) were obtained in 61 patients (78%). Among those with long-term follow-up data, overt bleeding before spiral enteroscopy was present in 62%, compared with 26% in the follow-up period (P < .0001). The mean (± SD) hemoglobin value increased from 10.6 ± 1.8 to 12.6 ± 1.9 g/dL (P < .0001). Blood transfusion requirements decreased by a mean of 4.19 units per patient (P = .0002), and the need for iron supplementation (P = .0487) and additional procedures (P < .0001) decreased in the follow-up period. There were 8 adverse events (9%) (7 mild, 1 moderate).
  
  
  CONCLUSIONS
  Single-center study, intervention bias.
  
  
  CONCLUSIONS
  In patients with obscure GI bleeding, deep small-bowel spiral enteroscopy is safe and effective in reducing the incidence of overt bleeding. An increase in hemoglobin values along with a decrease in blood transfusion requirement, need for iron supplementation, and need for additional therapeutic procedures were found over long-term follow-up. (
  
  
  BACKGROUND
  NCT00861263.).
authors: Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
authors: J Blair
authors: JB
authors: Williamson
authors: Joel R
authors: JR
authors: Judah
authors: Jill K J
authors: JK
authors: Gaidos
authors: Dennis P
authors: DP
authors: Collins
authors: Mihir S
authors: MS
authors: Wagh
authors: Shailendra S
authors: SS
authors: Chauhan
authors: Shabnam
authors: S
authors: Zoeb
authors: Jonathan M
authors: JM
authors: Buscaglia
authors: Hui
authors: H
authors: Yan
authors: Wei
authors: W
authors: Hou
authors: Peter V
authors: PV
authors: Draganov
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006454:Hemoglobins / Q000378:metabolism; D016558:Hemostasis, Endoscopic; D006801:Humans; D007410:Intestinal Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007421:Intestine, Small / Q000473:pathology; D007501:Iron / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D014131:Trace Elements / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D014131:Trace Elements; D007501:Iron