title: Single-balloon enteroscopy efficacy and degree of concordance with noninvasive evaluation of small bowel.
abstract: Background and study aimsClinical impact of single-balloon enteroscopy (SBE) is fairly known, as well as its diagnostic yield comparing with other small bowel gastrointestinal investigations. This study represents a contribution to better understand it and is designed to evaluate SBE efficacy and degree of concordance with previous evaluation of small bowel.Patients and methodsThis is a single-center retrospective study of patients that underwent SBE with suspected small bowel disease based on non-invasive imaging. Demographic, clinical, procedural and outcome data were collected for analysis. Agreement beyond positive findings was evaluated using κ-coefficient.ResultsA total of 197 SBEs were performed in 168 patients; mainly men (64.3 %) with mean age 53.3±17.6 years. Most SBEs (86.3 %) performed were preceded by a noninvasive evaluation: in 61.4 % (n = 119) of cases, capsule enteroscopy (CE) was performed, in 18.8 % (n = 37), computed tomography was performed, and in 6.1 % (n = 12) magnetic resonance enterography was performed. Fourty-three patients (25.6 %) underwent endoscopic treatments, mainly: argon plasma coagulation in angioectasias (53.4 %) and polypectomy (34.9 %). The most common diagnoses made with SBE were findings consistent with inflammatory small bowel disease (21.8 %) and vascular lesions (14.2 %). The diagnostic yield of SBE was of 69 %, confirming the suspicion of small bowel disease. The degree of concordance between CE and SBE for positive findings was substantial, κ-coefficient = 0.635 (P< 0.001). However, the degree of concordance between imaging examinations (CT or MR) and SBE was only moderate, κ-coefficient = 0.410 (P< 0.001). SBE had an immediate effect in 20 % of patients, changing diagnostic approaches, medical and surgical treatments.ConclusionsOur study supports the idea that for suspected small bowel disease, CE and SBE have an overall good degree of concordance for all the diagnostics included.
authors.affiliation: Gastroenterology Department, Centro Hospitalar São João, Porto (Porto).
authors.forename: Margarida
authors.initials: M
authors.lastname: Marques
authors.affiliation: Gastroenterology Department, Centro Hospitalar São João, Porto (Porto).
authors.forename: João
authors.initials: J
authors.lastname: Santos-Antunes
authors.affiliation: Gastroenterology Department, Centro Hospitalar São João, Porto (Porto).
authors.forename: Rosa
authors.initials: R
authors.lastname: Coelho
authors.affiliation: Gastroenterology Department, Centro Hospitalar São João, Porto (Porto).
authors.forename: Hélder
authors.initials: H
authors.lastname: Cardoso
authors.affiliation: Gastroenterology Department, Centro Hospitalar São João, Porto (Porto).
authors.forename: Filipe
authors.initials: F
authors.lastname: Vilas Boas
authors.affiliation: Gastroenterology Department, Centro Hospitalar São João, Porto (Porto).
authors.forename: Armando
authors.initials: A
authors.lastname: Ribeiro
authors.affiliation: Gastroenterology Department, Centro Hospitalar São João, Porto (Porto).
authors.forename: Guilherme
authors.initials: G
authors.lastname: Macedo