Background and Study Aims: Using push enteroscopy, the small bowel can only be investigated in part. This preliminary prospective randomized study examined whether increasing the length of the enteroscope can have a beneficial effect on the insertion depth.
Patients and Methods: Between August 1999 and December 1999, 28 consecutive patients were investigated using push enteroscopy and were randomly assigned to two groups. One group was investigated using the Olympus push enteroscope SIF-100 (working length 2200 mm). In the other group, the Olympus push enteroscope SIF-Q140 (working length 2500 mm) was used. All investigations were carried out using an overtube. The insertion depth was estimated by counting the folds in the small bowel. In addition, the insertion length was estimated in centimeters by withdrawing the instrument to the pylorus after straightening.
Results: The two groups were comparable in terms of age, sex distribution, indication for enteroscopy, investigation time, and pathological findings. There were no significant differences in the insertion length between the two types of instrument. With the SIF-100, the median number of folds was 95 (range 30 - 213) and the insertion length was 72.5 cm (range 40 - 110 cm); and with the SIF-Q140, the median number of folds was 79 (range 18 - 203) and the insertion length was 70.0 cm (range 20 - 140 cm).
Conclusions: As there was no significant difference in the insertion depth between the shorter instrument (Olympus SIF-100) and the longer one (Olympus SIF-Q140), it can be concluded from this preliminary study that there is no advantage in using a longer enteroscope. To document a significant difference, further studies with a larger numbers of patients would be necessary.
References
-
1
Davies G R, Benson M J, Gertner D J. et al .
Diagnostic and therapeutic push type enteroscopy in clinical use.
Gut.
1995;
37
346-352
-
2
Rossini F P, Arrigoni A, Penazzio M.
Clinical enteroscopy.
J Clin Gastroenterol.
1996;
22
231-235
-
3
O'Mahony S, Morris A J, Straiton M. et al .
Push enteroscopy in the investigation of small-intestinal disease.
Q J Med.
1996;
89
685-690
-
4
Benz C, Martin W R, Arnold J. et al .
Die endoskopische Untersuchung des Dünndarms mit Push-Enteroskopie. Eine prospektive Untersuchung.
Dtsch Med Wochenschr.
1997;
122
391-395
-
5
Landi B, Tkoub M, Gaudrick M. et al .
Diagnostic yield of push-type enteroscopy in relation to indication.
Gut.
1998;
42
421-425
-
6
MacKenzie J F.
Push enteroscopy.
Gastrointest Endosc Clin N Am.
1999;
9
29-36
-
7
Lewis B S.
The history of enteroscopy.
Gastrointest Endosc Clin N Am.
1999;
9
1-11
-
8
Foutch P G, Sawyer R, Sanoswki R A.
Push-enteroscopy for diagnosis of patients with gastrointestinal bleeding of obscure origin.
Gastrointest Endosc.
1990;
36
337-341
-
9
Benz C, Jakobs R, Riemann J F.
Do we need the overtube for the push-enteroscopy?.
Endoscopy.
2001;
33
658-661
-
10
Taylor A CF, Chen R YM, Desmond P V.
Use of an overtube for enteroscopy: does it increase depth of insertion? A prospective study of enteroscopy with and without overtube.
Endoscopy.
2001;
33
227-230
-
11
Iddan G, Meron G, Glukhovsky A, Swain P.
Wireless capsule endoscopy.
Nature.
2000;
405
417
-
12
Waye J D.
Small-bowel endoscopy.
Endoscopy.
1998;
30
133-140
-
13
Benz C, Martin W R, Maier M. et al .
Sonde-type enteroscopy vs. push-type enteroscopy for diagnosis of obscure gastrointestinal bleeding: which is the better choice? [abstract].
Gastroenterology.
1996;
110
312
-
14
Morris A J, Mokhashi M, Straiton M. et al .
Push enteroscopy and heater probe therapy for small bowel bleeding.
Gastrointest Endosc.
1996;
44
394-397
-
15
Barkin J S, Chong J, Reiner D K.
First-generation video enteroscope: fourth-generation push-type small bowel enteroscopy utilizing an overtube.
Gastrointest Endosc.
1994;
40
743-747
-
16
Perez-Cuadrado E, Macenlle R, Iglesias J. et al .
Usefulness of oral video push enteroscopy in Crohn's disease.
Endoscopy.
1997;
29
745-747
-
17
Bouhnik Y, Bitoun A, Coffin B.
Two-way push video enteroscopy in investigation of small-bowel disease.
Gut.
1998;
43
280-284
C. Benz, M.D.
Dept. of Gastroenterology · Evangelisches Krankenhaus Köln-Weyertal
Weyertal 76 · 50931 Köln · Germany
Fax: + 49-221-4792564
Email: Soyez.Benz @t-online.de
