Download PDF
Endoscopy 2022; 54(11): 1034-1042
DOI: 10.1055/a-1783-4802
Original article

The performance and safety of motorized spiral enteroscopy, including in patients with surgically altered gastrointestinal anatomy: a multicenter prospective study

Abdulbaqi Al-Toma 
1   Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, The Netherlands
,
Hanneke Beaumont
2   Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location VUMC, Amsterdam, The Netherlands
,
Jan Jacob Koornstra
3   Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
,
Petra van Boeckel
1   Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, The Netherlands
,
Dorien Oude Hergelink
3   Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
,
Jolein van der Kraan
4   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
,
Akin Inderson
4   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
,
Rogier de Ridder
5   Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands
,
Maarten Jacobs
2   Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location VUMC, Amsterdam, The Netherlands
› Author AffiliationsTrial Registration: ClinicalTrials.gov Registration number (trial ID): NCT04884113 Type of study: Prospective Multicenter Study
› Further Information
Also available at
    Permissions and Reprints


Referred to by:

The return of the helix: an evaluation of motorized spiral enteroscopy in actual daily clinical practice; a few points to “torque” about and ponder upon…Endoscopy 2022; 54(11): 1043-1044
DOI: 10.1055/a-1866-3917

Referred to by:

Author commentary on Abdulbaqi Al-Toma et al.Endoscopy 2022; 54(11): v37-v37
DOI: 10.1055/a-1836-2842

Abstract

Background Data are scarce on the efficacy and safety of motorized spiral enteroscopy (MSE). No data are available on the utility of this technique in patients with surgically altered gastrointestinal (GI) anatomy. We aimed to evaluate the safety and efficacy of MSE in patients with suspected small-bowel disease, including those with surgically altered GI anatomy.

Methods A multicenter prospective observational, uncontrolled study evaluated MSE in consecutive patients with suspected small-bowel pathology and an indication for diagnostic and/or therapeutic intervention.

Results A total of 170 patients (102 men; median age 64 years, range 18–89) were included. The overall diagnostic yield was 64.1 %. Endotherapy was performed in 53.5 % of procedures. The median total procedure times for the antegrade and retrograde approaches were 45 minutes (interquartile range [IQR] 30–80) and 40 minutes (IQR 30–70), respectively. When total (pan)enteroscopy was intended, this was achieved at rate of 70.3 % (28.1 % by antegrade approach and 42.2 % by a bidirectional approach). Surgically altered GI anatomy was present in 34 /170 of all procedures (20.0 %) and in 11 /45 of the successful total enteroscopy procedures (24.4 %). Propofol sedation or general anesthesia were used in 92.9 % and 7.1 % of the procedures, respectively. Minor adverse events were observed in 15.9 % of patients, but there were no major adverse events.

Conclusion MSE seems to be an effective and safe endoscopic procedure. Total (pan)enteroscopy can be achieved, in one or two sessions, even in the presence of surgically altered GI anatomy. The total procedure time is relatively short. For both antegrade and retrograde MSE procedures, propofol sedation seems sufficient and safe.

Fig. 1 s, Tables 1 s, 2 s



Publication History

Received: 21 October 2021

Accepted after revision: 28 February 2022

Accepted Manuscript online:
28 February 2022

Article published online:
06 May 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Schneider M, Höllerich J, Beyna T. Device-assisted enteroscopy: A review of available techniques and upcoming new technologies. World J Gastroenterol 2019; 25: 3538-3545
    CrossrefPubMedGoogle Scholar
  • 2 Yamamoto H, Kita H. Enteroscopy. J Gastroenterol 2005; 40: 555-562
    CrossrefPubMedGoogle Scholar
  • 3 Akerman PA, Agrawal D, Chen W. et al. Spiral enteroscopy: a novel method of enteroscopy by using the Endo-Ease Discovery SB overtube and a pediatric colonoscope. Gastrointest Endosc 2009; 69: 327-332
    CrossrefPubMedGoogle Scholar
  • 4 Heine GD, Al-Toma A, Mulder CJJ. et al. Milestone in gastrointestinal endoscopy: double-balloon enteroscopy of the small bowel. Scand J Gastroenterol 2006; 243: S32-S38
    CrossrefPubMedGoogle Scholar
  • 5 Rahmi G, Samaha E, Vahedi K. et al. Multicenter comparison of double-balloon enteroscopy and spiral enteroscopy. J Gastroenterol Hepatol 2013; 28: 992-998
    CrossrefPubMedGoogle Scholar
  • 6 Neuhaus H, Beyna T, Schneider M. et al. Novel motorized spiral enteroscopy: first clinical case. VideoGIE 2016; 1: 32-33
    CrossrefPubMedGoogle Scholar
  • 7 Ramchandani M, Rughwani H, Inavolu P. et al. Diagnostic yield and therapeutic impact of novel motorized spiral enteroscopy in small-bowel disorders: a single-center, real-world experience from a tertiary care hospital (with video). Gastrointest Endosc 2021; 93: 616-626
    CrossrefPubMedGoogle Scholar
  • 8 Beyna T, Arvanitakis M, Schneider M. et al. Motorised spiral enteroscopy: First prospective clinical feasibility study. Gut 2021; 70: 261-267
    PubMedGoogle Scholar
  • 9 Inavolu P, Singh AP, Kanakagiri H. et al. Motorized spiral enteroscope-assisted retrieval of video capsule in a patient with Crohn’s disease. VideoGIE 2020; 5: 488-491
    CrossrefPubMedGoogle Scholar
  • 10 Beyna T, Arvanitakis M, Schneider M. et al. Total motorized spiral enteroscopy: first prospective clinical feasibility trial. Gastrointest Endosc 2021; 93: 1362-1370
    Google Scholar
  • 11 Tang RSY, Wong MTL, Lai JCT. et al. Total enteroscopy by antegrade motorized spiral enteroscopy under conscious sedation for acute overt obscure gastrointestinal bleeding. Endoscopy 2020; 52: E251-E252
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Rondonotti E, Spada C, Adler S. et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review. Endoscopy 2018; 50: 423-446
    Google Scholar
  • 13 Irfan M, Ahmed M, Breen D. Assessment of high flow nasal cannula oxygenation in endobronchial ultrasound bronchoscopy: a randomized controlled trial. J Bronchol Interv Pulmonol 2021; 28: 130-137
    CrossrefPubMedGoogle Scholar
  • 14 Miguel-Montanes R, Hajage D, Messika J. et al. Use of high-flow nasal cannula oxygen therapy to prevent desaturation during tracheal intubation of intensive care patients with mild-to-moderate hypoxemia. Crit Care Med 2015; 43: 574-583
    CrossrefPubMedGoogle Scholar
  • 15 Baniya R, Upadhaya S, Subedi SC. et al. Balloon enteroscopy versus spiral enteroscopy for small-bowel disorders: a systematic review and meta-analysis. Gastrointest Endosc 2017; 86: 997-1005
    CrossrefPubMedGoogle Scholar
  • 16 May A, Manner H, Aschmoneit I. et al. Prospective, cross-over, single-center trial comparing oral double-balloon enteroscopy and oral spiral enteroscopy in patients with suspected small-bowel vascular malformations. Endoscopy 2011; 43: 477-4833
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Xin L, Liao Z, Jiang YP. et al. Indications, detectability, positive findings, total enteroscopy, and complications of diagnostic double-balloon endoscopy: A systematic review of data over the first decade of use. Gastrointest Endosc 2011; 74: 563-570
    Google Scholar
  • 18 Upchurch BR, Sanaka MR, Lopez AR. et al. The clinical utility of single-balloon enteroscopy: a single-center experience of 172 procedures. Gastrointest Endosc 2010; 71: 1218-1223
    CrossrefPubMedGoogle Scholar
  • 19 Khashab MA, Lennon AM, Dunbar KB. et al. A comparative evaluation of single-balloon enteroscopy and spiral enteroscopy for patients with mid-gut disorders. Gastrointest Endosc 2010; 72: 766-772
    CrossrefPubMedGoogle Scholar
  • 20 Morgan D, Upchurch B, Draganov P. et al. Spiral enteroscopy: prospective U.S. multicenter study in patients with small-bowel disorders. Gastrointest Endosc 2010; 72: 992-998
    CrossrefPubMedGoogle Scholar
  • 21 Moran RA, Barola S, Law JK. et al. A randomized controlled trial comparing the depth of maximal insertion between anterograde single-balloon versus spiral enteroscopy. Clin Med Insights Gastroenterol 2018; 11 DOI: 10.1177/1179552218754881.
    CrossrefPubMedGoogle Scholar
  • 22 May A, Färber M, Aschmoneit I. et al. Prospective multicenter trial comparing push-and-pull enteroscopy with the single- and double-balloon techniques in patients with small-bowel disorders. Am J Gastroenterol 2010; 105: 575-581
    CrossrefPubMedGoogle Scholar
  • 23 Lenz P, Domagk D. Double- vs. single-balloon vs. spiral enteroscopy. . Best Pract Res Clin Gastroenterol 2012; 26: 303-313
    CrossrefPubMedGoogle Scholar
  • 24 Takano N, Yamada A, Watabe H. et al. Single-balloon versus double-balloon endoscopy for achieving total enteroscopy: A randomized, controlled trial. Gastrointest Endosc 2011; 73: 734-739
    CrossrefPubMedGoogle Scholar
  • 25 Yamamoto H, Yano T, Ohmiya N. et al. Double-balloon endoscopy is safe and effective for the diagnosis and treatment of small-bowel disorders: Prospective multicenter study carried out by expert and non-expert endoscopists in Japan. Dig Endosc 2015; 27: 331-337
    CrossrefPubMedGoogle Scholar
  • 26 Ramchandani M, Reddy DN, Gupta R. et al. Diagnostic yield and therapeutic impact of single-balloon enteroscopy: Series of 106 cases. J Gastroenterol Hepatol 2009; 24: 1631-1638
    CrossrefPubMedGoogle Scholar