title: Prior capsule endoscopy improves the diagnostic and therapeutic yield of single-balloon enteroscopy.
abstract: OBJECTIVE
  Although there is substantial literature addressing double-balloon enteroscopy, evidence is more limited with regard to the clinical utility of single-balloon enteroscopy (SBE) in evaluating and treating small-bowel diseases. We sought to determine the diagnostic and therapeutic yield of SBE in patients with suspected small-bowel disorders, as well as the impact of preceding capsule endoscopy (CE) on these outcomes.
  
  
  METHODS
  We performed a retrospective analysis of a prospectively collected database at a tertiary-care academic medical center between 2011 and 2013 for all patients referred for SBE.
  
  
  RESULTS
  A total of 150 patients underwent 170 SBE procedures during the study period. The most frequent indications for SBE included anemia, overt or occult gastrointestinal bleeding, and suspected mass. CE was performed prior to SBE in 113 of 150 patients (75%). The overall diagnostic yield for small-bowel disease by CE was 62%. Therapeutic interventions included hemostasis, polypectomy, and foreign body removal. Total diagnostic and therapeutic yield of SBE was 60 and 28%, respectively. The diagnostic yield of SBE with prior CE was 68 versus 44% for SBE without prior CE (P = 0.002). The therapeutic yield of SBE with prior CE was 35 versus 12% without prior CE (P = 0.001). One endoscopic complication was observed out of 170 procedures, and there were no deaths.
  
  
  CONCLUSIONS
  SBE appears to be a safe and effective technique for the diagnosis and treatment of small-bowel disease; however, we recommend performing a CE prior to SBE to improve the diagnostic and therapeutic yield of the procedure.
authors.affiliation: Division of Gastroenterology, Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Sethi
authors.forename: Jonah
authors.initials: J
authors.lastname: Cohen
authors.forename: Adarsh M
authors.initials: AM
authors.lastname: Thaker
authors.forename: Sagar
authors.initials: S
authors.lastname: Garud
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Sawhney
authors.forename: Ram
authors.initials: R
authors.lastname: Chuttani
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Pleskow
authors.forename: Kenneth
authors.initials: K
authors.lastname: Falchuk
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Berzin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult