Motorized spiral enteroscopy – our first experience

Česká verzia

Authors: Falt P. ^1,2; Tichý T. ¹; Urban O. ¹
Authors place of work: II. interní klinika – gastroenterologická a geriatrická LF UP a FN Olomouc2 II. interní gastroenterologická klinika LF UK v Hradci Králové ¹
Published in the journal: Gastroent Hepatol 2020; 74(3): 212-216
Category: Digestivní endoskopie: původní práce
doi: https://doi.org/10.14735/amgh2020212

Summary

Introduction: Motorized spiral enteroscopy (PSE – PowerSpiral enteroscopy) is a novel enteroscopy platform intended for both oral and anal approach. Limited data suggest efficacy and safety comparable to other deep enteroscopy techniques. Our study consists in analysis of our first series of patients examined by PSE.

Methods: All consecutive patients indicated for PSE in single tertiary endoscopic center were prospectively followed. The main outcomes were technical success defined as passage beyond ligamentum of Treitz or ileocecal valve, reaching required segment of the small bowel, complication rate and success rate of total enteroscopy, if indicated.

Results: Between June 2019 and February 2020, a total of 21 PSE procedures in 15 patients were performed, 11 from oral and 10 from anal approach. PSE was technically successful in 100% (21/21) and required segment of the small bowel was reached in 81% (17/21) of cases. Total enteroscopy was indicated in two patients and it was achieved in both. In 40% (6/15) of patients, pathological condition of the small bowel was found. Complications occurred in 10% (2/21) of cases: mild acute pancreatitis and intussusception of the sigmoid during enteroscope extraction. We observed clinically insignificant mucosal bruising caused by spiral rotation in all patients.

Conclusion: In our series of 21 examinations in 15 patients, we demonstrate high technical and diagnostic success rate of PSE associated with low rate of conservatively treated complications.

Keywords:

Small intestine – motorized spiral enteroscopy – device-assisted enteroscopy

Zdroje

1. Pennazio M, Spada C, Eliakim R et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 2015; 47 (4): 352–376. doi: 10.1055/s-0034-1391855.

2. Schneider M, Höllerich J, Beyna T. Device-assisted enteroscopy: a review of available techniques and upcoming new technologies. World J Gastroenterol 2019; 25 (27): 3538–3545. doi: 10.3748/wjg.v25.i27.3538.

3. Beyna T, Arvanitakis M, Schneider M et al. UEG week: oral presentation. Motorized spiral enteroscopy: final results a two-center prospective clinical trial. United European Gastroenterol J 2018; 6 (8) (Suppl 1): A88. doi: 10.1177/2050640618792817.

4. Beyna T, Arvanitakis M, Schneider M et al. First prospective clinical trial on total motorized spiral enteroscopy (TMSET). GIE 2019; 89 (6) (Suppl 1): AB48. doi: 10.1016/j.gie.2019.04.002.

5. Veitch AM, Vanbiervliet G, Gershlick AH et al. Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Endoscopy 2016; 48 (4): 385–402. doi: 10.1055/s-0042-102652.

6. Neuhaus H, Beyna T, Schneider M et al. Novel motorized spiral enteroscopy: first clinical case. VideoGIE 2016; 1 (2): 32–33. doi: 10.1016/j.vgie.2016.08.005.

7. Beyna T, Schneider M, Pullmann D et al. Motorized spiral colonoscopy: a first single-center feasibility trial. Endoscopy 2018; 50 (5): 518–523. doi: 10.1055/s-0043-123577.

8. Kopacova M, Tacheci I, Rejchrt S et al. Double balloon enteroscopy and acute pancreatitis. World J Gastroenterol 2010; 16 (19): 2331–2340. doi: 10.3748/wjg.v16.i19.2331.

9. Chaze I, Gincul R, Lepilliez V et al. Gastroesophageal intussusception and multivisceral failure after per oral spiral enteroscopy. VideoGIE 2013; 1 (1): 230–232. doi: 10.1016/S2212-0971 (13) 70098-0.

10. Rahmi G, Brieau B, Samaha E et al. Jejunojejunal intussusception after polypectomy by spiral enteroscopy in Peutz-Jeghers syndrome. Endoscopy 2015; 47 (Suppl 1): UCTN: E540–E541. doi: 10.1055/s-0034-1393151.