Akerman P A, Agrawal D, Cantero D, Pangtay J
Rhode Island Hospital, Brown University, Providence, Rhode Island 02905, USA.
Endoscopy. 2008 Dec;40(12):974-8. doi: 10.1055/s-0028-1103402. Epub 2008 Dec 8.
Spiral enteroscopy is a new technique for deep small-bowel intubation that uses a special overtube (Discovery Small Bowel, DSB) to pleat small bowel. The aims of this prospective study were to evaluate the use of a new-design DSB over new, longer and smaller-diameter enteroscopes, the Fujinon EN-450T5 and the Olympus SIF-Q180.
This is a prospective study of 75 patients at two referral centers. All enteroscopies were performed by two experienced endoscopists. Patients underwent spiral enteroscopy perorally with the DSB and either the Fujinon EN-450T5 or the Olympus SIF-Q180 enteroscope. Procedure time and depth of insertion past the ligament of Treitz were determined for all patients.
Peroral spiral enteroscopy with DSB was performed in 50 patients with the Fujinon enteroscope and in 25 patients with the Olympus. Average estimated depth of insertion was 243 cm (range 50 - 380 cm) vs. 256 cm (range 50 - 400 cm) and the average time to reach this depth was 18.7 minutes (range 7 - 52 minutes) vs. 16.2 minutes (range 7 - 33 minutes) in the Fujinon and the Olympus groups respectively. Overall findings were 10 angiodysplasias, 2 small-bowel tumors, 1 Peutz-Jeghers polyp, 1 case of celiac sprue, 2 of small-bowel strongyloidiasis, and 2 small-bowel ulcers. All angiodysplasias were treated with bipolar cauterization. Biopsies were taken from the small-bowel tumors. There were no major complications.
The new DSB is a means of rapid, safe, and effective deep small-bowel intubation. Depth of insertion into the small bowel and total procedure time compare favorably with other deep enteroscopy techniques. The DSB performed equally well with both enteroscopes.
螺旋式小肠镜检查是一种用于深入小肠插管的新技术，它使用一种特殊的外套管（探索型小肠外套管，DSB）来折叠小肠。这项前瞻性研究的目的是评估新型设计的DSB在新型、更长且直径更小的小肠镜（富士能EN-450T5和奥林巴斯SIF-Q180）上的应用情况。
这是一项在两个转诊中心对75例患者进行的前瞻性研究。所有小肠镜检查均由两名经验丰富的内镜医师进行。患者经口使用DSB及富士能EN-450T5或奥林巴斯SIF-Q180小肠镜进行螺旋式小肠镜检查。测定所有患者的操作时间及通过屈氏韧带的插入深度。
50例患者使用富士能小肠镜、25例患者使用奥林巴斯小肠镜经口进行了DSB螺旋式小肠镜检查。富士能组和奥林巴斯组的平均估计插入深度分别为243厘米（范围50 - 380厘米）和256厘米（范围50 - 400厘米），达到该深度的平均时间分别为18.7分钟（范围7 - 52分钟）和16.2分钟（范围7 - 33分钟）。总体检查发现10处血管发育异常、2个小肠肿瘤、1个黑斑息肉病息肉、1例乳糜泻、2例小肠类圆线虫病和2处小肠溃疡。所有血管发育异常均采用双极电凝治疗。从小肠肿瘤处取了活检。未发生重大并发症。
新型DSB是一种快速、安全且有效的深入小肠插管方法。小肠插入深度和总操作时间与其他深部小肠镜检查技术相比具有优势。DSB在两种小肠镜上的表现同样出色。
