title: Factors associated with reduced insertion depth at double balloon enteroscopy: a retrospective, multivariate analysis.
abstract: BACKGROUND
  Deep small bowel insertion during double balloon enteroscopy can be difficult to achieve.
  
  
  OBJECTIVE
  To determine the factors influencing depth of insertion during double balloon enteroscopy.
  
  
  METHODS
  History of abdomino-pelvic surgery, route of insertion, type of enteroscope, age, sedation or general anaesthesia used and gender were considered as potential influencing factors; procedures were categorised accordingly and maximal depth of insertion calculated.
  
  
  RESULTS
  At multivariate analysis, maximal depth of insertion was significantly associated with history of abdominal-pelvic surgery (P<0.001), rectal approach (P=0.011), gender (P=0.02) and use of the therapeutic enteroscope (P=0.047). Mean maximal depth of insertion was 266±12cm, 255±9cm (P=0.50), 197±10cm (P<0.0001), 160±12cm (P<0.01) and 103±33cm (P<0.15) when 0, 1, 2, 3 and 4 influencing factors were present, respectively.
  
  
  CONCLUSIONS
  Maximal depth of insertion was significantly influenced by history of abdomino-pelvic surgery, insertion route, gender and type of enteroscope used.
authors: Wolfson Unit for Endoscopy, St. Mark's Hospital and Academic Institute, Imperial College London, UK. Electronic address: albertomurino@yahoo.it.
authors: Alberto
authors: A
authors: Murino
authors: Wolfson Unit for Endoscopy, St. Mark's Hospital and Academic Institute, Imperial College London, UK.
authors: Masanao
authors: M
authors: Nakamura
authors: Wolfson Unit for Endoscopy, St. Mark's Hospital and Academic Institute, Imperial College London, UK.
authors: Edward J
authors: EJ
authors: Despott
authors: Wolfson Unit for Endoscopy, St. Mark's Hospital and Academic Institute, Imperial College London, UK.
authors: Chris
authors: C
authors: Fraser
mesh_terms: D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D058582:Double-Balloon Enteroscopy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010388:Pelvis / Q000601:surgery; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult
keywords: Double balloon enteroscopy; Enteroscopy; Maximal depth of insertion; Small bowel