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单气囊小肠镜的临床应用:单中心 172 例操作经验。

The clinical utility of single-balloon enteroscopy: a single-center experience of 172 procedures.

机构信息

Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.

出版信息

Gastrointest Endosc. 2010 Jun;71(7):1218-23. doi: 10.1016/j.gie.2010.01.012. Epub 2010 Apr 20.

Abstract

BACKGROUND

Single-balloon enteroscopy (SBE) is a novel endoscopic technique designed to evaluate and treat small-bowel disease. Although there is substantial literature addressing double-balloon enteroscopy and its impact on the diagnosis and management of small-bowel disease, there are limited data available on the clinical utility of SBE.

OBJECTIVES

To evaluate the clinical utility and diagnostic impact of SBE in a large cohort of patients at a single tertiary center.

DESIGN

Single-center, retrospective study.

SETTING

Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio.

PATIENTS

A total of 161 patients were referred for SBE from January 2006 to August 2008.

MAIN OUTCOME MEASUREMENTS

Demographic, clinical, procedural, and outcome data were collected and analyzed.

RESULTS

A total of 161 patients underwent a total of 172 procedures. Antegrade and retrograde approaches were used in 83% and 17% of subjects, respectively. The average insertion depth using the antegrade approach was 132 cm beyond the ligament of Treitz (range 20-400 cm). The average insertion depth using the retrograde approach was 73 cm above the ileocecal valve (range 10-160 cm). The average procedure time was 40 minutes overall, 38 minutes (range 12-90) antegrade and 48 minutes (range 28-89) retrograde. Fluoroscopy was used in 20 cases (12%). Diagnostic yield was 58% (99/172); 42% (72/172) were therapeutic cases. There were no significant complications.

LIMITATIONS

Single-center, retrospective study.

CONCLUSIONS

SBE demonstrated a high diagnostic yield and frequently provided useful therapeutic intervention. It seems to be a safe and effective method for performing deep enteroscopy.

摘要

背景

单气囊小肠镜(SBE)是一种新型内镜技术,旨在评估和治疗小肠疾病。虽然有大量文献涉及双气囊小肠镜及其对小肠疾病的诊断和治疗的影响,但关于 SBE 的临床实用性的数据有限。

目的

在单一的三级中心,评估 SBE 在大量患者中的临床实用性和诊断影响。

设计

单中心、回顾性研究。

地点

克利夫兰诊所消化疾病研究所,俄亥俄州克利夫兰。

患者

共有 161 例患者于 2006 年 1 月至 2008 年 8 月期间因 SBE 被转诊。

主要观察指标

收集并分析了人口统计学、临床、程序和结果数据。

结果

共有 161 例患者共进行了 172 次检查。顺行和逆行方法分别在 83%和 17%的患者中使用。使用顺行方法的平均插入深度为超过Treitz 韧带 132cm(范围 20-400cm)。使用逆行方法的平均插入深度为回盲瓣上方 73cm(范围 10-160cm)。总的手术时间平均为 40 分钟,顺行 38 分钟(范围 12-90 分钟),逆行 48 分钟(范围 28-89 分钟)。20 例(12%)使用了透视。诊断率为 58%(99/172);42%(72/172)为治疗病例。无严重并发症。

局限性

单中心、回顾性研究。

结论

SBE 显示出较高的诊断率,并经常提供有用的治疗干预。它似乎是一种安全有效的深部内镜检查方法。

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