Akerman Paul A, Cantero Daniel
Brown University, Providence, RI, USA.
Gastrointest Endosc Clin N Am. 2009 Jul;19(3):357-69. doi: 10.1016/j.giec.2009.04.001.
Spiral enteroscopy is a new technique for endoscopic evaluation of the small bowel. Currently, more than 3000 cases have been performed worldwide. The Discovery SB device has been approved by the Food and Drug Administration and has been granted a CE mark. The technique is safe and effective for management and detection of small bowel pathology. Recent studies of spiral enteroscopy have demonstrated diagnostic yield, total time of procedure, and depth of insertion that compare favorably with double and single balloon enteroscopy. The strengths of spiral enteroscopy are rapid advancement in the small bowel and controlled, stable withdrawal that facilitates therapy. Future studies will be needed to compare competing technologies. Push enteroscopy is a readily available, safe and effective technique for detecting and treating proximal gut pathology. If performed without an overtube, complications are rare. Use of a dedicated push enteroscope with an overtube is generally reserved for specific indications in which a moderate increase in depth of insertion into the small bowel is required. When capsule endoscopy and deep small bowel enteroscopy are not available, push enteroscopy is a reasonable option with low risk and moderate yield. Push enteroscopy will remain an important part of the armamentarium of the modern endoscopist.
螺旋式小肠镜检查是一种用于小肠内镜评估的新技术。目前，全球已进行了3000多例该检查。Discovery SB设备已获得美国食品药品监督管理局的批准，并已获得CE标志。该技术对于小肠病变的管理和检测是安全有效的。最近关于螺旋式小肠镜检查的研究表明，其诊断率、总操作时间和插入深度与双气囊和单气囊小肠镜检查相比具有优势。螺旋式小肠镜检查的优点是在小肠内推进迅速，回撤可控且稳定，便于治疗。未来需要进行研究以比较相互竞争的技术。推送式小肠镜检查是一种用于检测和治疗近端肠道病变的现成、安全且有效的技术。如果不使用外套管进行操作，并发症很少见。使用带有外套管的专用推送式小肠镜通常仅用于需要适度增加小肠插入深度的特定适应症。当无法进行胶囊内镜检查和深部小肠镜检查时，推送式小肠镜检查是一种风险低、收益中等的合理选择。推送式小肠镜检查仍将是现代内镜医师工具库的重要组成部分。
