Document Detail


Prospective multicenter trial comparing push-and-pull enteroscopy with the single- and double-balloon techniques in patients with small-bowel disorders.
MedLine Citation:
PMID:  20051942     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Double-balloon enteroscopy (DBE) is now an established method for diagnostic and therapeutic small-bowel endoscopy. Single-balloon enteroscopy (SBE) has been introduced to simplify the technique. A prospective randomized study was carried out to compare the two methods.
METHODS: The study included 100 patients (50 in each group; 63 men, 37 women; mean age 55 years), with no previous small-bowel or colon surgery. The indications for enteroscopy were (suspected) mid-gastrointestinal bleeding, Crohn's disease, small-bowel masses, chronic diarrhea or abdominal pain or both, and other conditions. Fujinon instruments were used, with either two balloons or one. The end point of the study was complete enteroscopy as the most objective parameter.
RESULTS: No severe complications such as perforation, bleeding, or pancreatitis occurred. Instrument preparation time was significantly faster with SBE than with DBE (P<0.0001). Complete enteroscopy was achieved with the DBE technique in 66% of cases (33 patients), either with the oral route alone or with combined oral and anal approaches. With the SBE technique, the complete enteroscopy rate was significantly lower at 22% (P<0.0001; 11 patients, only with oral and anal routes combined). The rate of therapeutic consequences for the patients based on diagnostic yield and negative complete enteroscopy was significantly higher (P=0.025) in the DBE group at 72%, compared with 48% in the SBE group.
CONCLUSIONS: The complete enteroscopy rate was three times higher with DBE than with SBE, accompanied by a higher diagnostic yield. DBE must therefore continue to be regarded as the nonsurgical gold standard procedure for deep small-bowel endoscopy.
Authors:
Andrea May; Michael Färber; Insa Aschmoneit; Jürgen Pohl; Hendrik Manner; Erich Lotterer; Oliver Möschler; Johannes Kunz; Liebwin Gossner; Klaus Mönkemüller; Christian Ell
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-01-05
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  105     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-04-15     Revised Date:  2011-02-02    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  575-81     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine II, Teaching Hospital of the University of Mainz, Wiesbaden, Germany. andrea.may@hsk-wiesbaden.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Diagnosis, Differential
Endoscopes, Gastrointestinal*
Endoscopy, Gastrointestinal / methods*
Female
Humans
Intestinal Diseases / diagnosis*,  therapy*
Intestine, Small*
Male
Middle Aged
Prospective Studies
Statistics, Nonparametric
Treatment Outcome
Comments/Corrections
Comment In:
Endoscopy. 2011 Jan;43(1):38-41   [PMID:  21108176 ]
Am J Gastroenterol. 2010 Mar;105(3):582-4   [PMID:  20203640 ]
Endoscopy. 2010 Jan;42(1):46-8   [PMID:  19899035 ]
Am J Gastroenterol. 2010 Nov;105(11):2504; author reply 2504-5   [PMID:  21048685 ]
Am J Gastroenterol. 2010 Sep;105(9):2112; author reply 2113   [PMID:  20818357 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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