Marques Margarida, Santos-Antunes João, Coelho Rosa, Cardoso Hélder, Vilas Boas Filipe, Ribeiro Armando, Macedo Guilherme
Gastroenterology Department, Centro Hospitalar São João, Porto (Porto).
Endosc Int Open. 2017 Feb;5(2):E96-E102. doi: 10.1055/s-0042-121415.
Clinical impact of single-balloon enteroscopy (SBE) is fairly known, as well as its diagnostic yield comparing with other small bowel gastrointestinal investigations. This study represents a contribution to better understand it and is designed to evaluate SBE efficacy and degree of concordance with previous evaluation of small bowel. This is a single-center retrospective study of patients that underwent SBE with suspected small bowel disease based on non-invasive imaging. Demographic, clinical, procedural and outcome data were collected for analysis. Agreement beyond positive findings was evaluated using κ-coefficient. A total of 197 SBEs were performed in 168 patients; mainly men (64.3 %) with mean age 53.3±17.6 years. Most SBEs (86.3 %) performed were preceded by a noninvasive evaluation: in 61.4 % (n = 119) of cases, capsule enteroscopy (CE) was performed, in 18.8 % (n = 37), computed tomography was performed, and in 6.1 % (n = 12) magnetic resonance enterography was performed. Fourty-three patients (25.6 %) underwent endoscopic treatments, mainly: argon plasma coagulation in angioectasias (53.4 %) and polypectomy (34.9 %). The most common diagnoses made with SBE were findings consistent with inflammatory small bowel disease (21.8 %) and vascular lesions (14.2 %). The diagnostic yield of SBE was of 69 %, confirming the suspicion of small bowel disease. The degree of concordance between CE and SBE for positive findings was substantial, κ-coefficient = 0.635 ( < 0.001). However, the degree of concordance between imaging examinations (CT or MR) and SBE was only moderate, κ-coefficient = 0.410 ( < 0.001). SBE had an immediate effect in 20 % of patients, changing diagnostic approaches, medical and surgical treatments. Our study supports the idea that for suspected small bowel disease, CE and SBE have an overall good degree of concordance for all the diagnostics included.
单气囊小肠镜检查(SBE)的临床影响已为人熟知,其与其他小肠胃肠道检查方法相比的诊断率也已明确。本研究有助于更好地了解SBE,并旨在评估SBE的疗效以及与先前小肠评估的一致性程度。这是一项单中心回顾性研究,研究对象为基于非侵入性成像怀疑患有小肠疾病而接受SBE检查的患者。收集人口统计学、临床、操作和结果数据进行分析。使用κ系数评估阳性结果以外的一致性。共对168例患者进行了197次SBE检查;主要为男性(64.3%),平均年龄53.3±17.6岁。大多数SBE检查(86.3%)之前进行了非侵入性评估:61.4%(n = 119)的病例进行了胶囊内镜检查(CE),18.8%(n = 37)进行了计算机断层扫描,6.1%(n = 12)进行了磁共振小肠造影。43例患者(25.6%)接受了内镜治疗,主要包括:血管扩张症的氩离子凝固术(53.4%)和息肉切除术(34.9%)。SBE最常见的诊断结果是与炎症性小肠疾病相符(21.8%)和血管病变(14.2%)。SBE的诊断率为69%,证实了对小肠疾病的怀疑。CE和SBE阳性结果的一致性程度较高,κ系数 = 0.635(<0.001)。然而,影像学检查(CT或MR)与SBE的一致性程度仅为中等,κ系数 = 0.410(<0.001)。SBE对20%的患者有即时影响,改变了诊断方法、药物和手术治疗。我们的研究支持这样一种观点,即对于疑似小肠疾病,CE和SBE对所有纳入的诊断总体上具有良好的一致性程度。