Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo.
Dig Endosc. 2013 Jul;25(4):406-11. doi: 10.1111/j.1443-1661.2012.01403.x. Epub 2012 Dec 5.
Despite recent advances in enteroscopy, such as balloon enteroscopy, accessing the small intestine remains challenging. Spiral enteroscopy is a novel technique in which an endoscope is fitted with a rotating overtube that has a soft spiral fin at the tip. Whereas spiral enteroscopy is beginning to be carried out in Western countries, it is not common in many Asian countries. The aim of the present study was to evaluate the efficacy and safety of spiral enteroscopy in Japanese patients.
We prospectively conducted spiral enteroscopy in patients with suspected or known small bowel disease. All procedures were carried out using a spiral overtube. The main outcome measurements of the study were diagnosis rate, endoscopic intervention rate, and complication rate.
Thirty-two patients underwent spiral enteroscopy. Spiral enteroscopy diagnosed 16 patients (50%) with small intestinal lesions, including six malignant lymphomas (19%), three erosions or ulcers (9%), three polyps (9%), two angioectasias (6%), one carcinoma (3%), and one submucosal tumor (3%). Additionally, four patients underwent endoscopic interventions (13%). Mallory-Weiss syndrome occurred in one patient (3%). No perforation occurred in any patient (0%).
Our initial experience of spiral enteroscopy suggests that it can be introduced safely, but it is relatively invasive and technically demanding. More experience is needed to conduct spiral enteroscopy easily and safely.
尽管近年来推进式小肠镜技术（如气囊式小肠镜）取得了进展，但小肠的检查仍具有挑战性。螺旋推进式小肠镜是一种新型技术，它在小肠镜的前端配备了一个带有软螺旋翼的旋转外套管。尽管螺旋推进式小肠镜已在西方国家开始应用，但在许多亚洲国家并不常见。本研究旨在评估螺旋推进式小肠镜在日本患者中的应用效果和安全性。
我们前瞻性地对疑似或已知患有小肠疾病的患者进行螺旋推进式小肠镜检查。所有操作均使用螺旋外套管进行。本研究的主要观察指标为诊断率、内镜干预率和并发症发生率。
共 32 例患者接受了螺旋推进式小肠镜检查。螺旋推进式小肠镜诊断出 16 例（50%）小肠病变患者，其中包括 6 例恶性淋巴瘤（19%）、3 例糜烂或溃疡（9%）、3 例息肉（9%）、2 例血管扩张（6%）、1 例癌（3%）和 1 例黏膜下肿瘤（3%）。此外，4 例患者进行了内镜干预（13%）。1 例（3%）患者发生了 Mallory-Weiss 综合征。无患者发生穿孔（0%）。
我们对螺旋推进式小肠镜的初步应用经验表明，该技术相对安全，但具有一定的侵袭性和技术难度。需要更多的经验才能使螺旋推进式小肠镜的操作变得简单、安全。
