The Jecheskiel Sigi Gonczarowski Pediatric Gastroenterology Unit.
The Gonczarowski Family Institute of Gastroenterology, Shamir (Assaf Harofeh) Medical Center and the Sackler School of Medicine, Tel Aviv University, Israel.
J Pediatr Gastroenterol Nutr. 2020 Jul;71(1):e6-e11. doi: 10.1097/MPG.0000000000002706.
Small bowel involvement in Crohn disease (CD) is clinically important for diagnosis and treatment. Single and double-balloon enteroscopy have already become important diagnostic tools in such cases. The on-demand NaviAid AB device enables deep advancement into the small bowel, using an anterograde or retrograde approach. In adults, this procedure is feasible, safe, and rapid. This work aimed to assess the safety and feasibility of NaviAid AB enteroscopy in pediatric patients.
Single-center, prospective study using the through-the-scope balloon-assisted-enteroscopy (TTS-BAE) NaviAid AB device for the evaluation of the small bowel in children with suspected or known inflammatory bowel disease (IBD). The system consists of a single-use balloon catheter inserted through the instrument channel of a standard colonoscope. It consists of an inflation/deflation system (NaviAid SPARK), which is inflated to anchoring pressure. The repetitive push-pull technique enables the advancement of the colonoscope along the small intestine.
Fifty analyzed endoscopic procedures (30 retrograde, 20 anterograde) were performed in 34 children (52.9% boys, mean age 13.7 years). Average maximal depth of insertion (MDI), advancement depth using the NaviAid AB and average total procedure time were 138 cm (range 100-190 cm), 81 cm (range 40-120 cm), and 12.8 minutes (range 7.3-19.0 minutes), respectively, for the anterograde approach and 143 cm (range 100-170 cm), 64 cm (range 20-95 cm), and 21.9 minutes (range 13.9-32.0 minutes), respectively, for the retrograde approach. No serious or device-related adverse events were reported.
NaviAid AB enteroscopy in children is safe, feasible, and enables assessment of the small intestine in a short period of time.
小肠受累是克罗恩病（CD）临床诊断和治疗的重要依据。单气囊和双气囊小肠镜已经成为这些病例的重要诊断工具。NaviAid AB 装置可通过顺行或逆行方法实现小肠的深度推进。在成人中，该程序是可行的、安全的且快速的。本研究旨在评估 NaviAid AB 小肠镜在儿科患者中的安全性和可行性。
采用单中心前瞻性研究，使用经内镜活检孔道的球囊辅助小肠镜（TTS-BAE）NaviAid AB 装置评估疑似或已知炎症性肠病（IBD）的儿童的小肠。该系统由一个一次性使用的球囊导管通过标准结肠镜的器械通道插入，由一个充气/放气系统（NaviAid SPARK）组成，该系统充气至锚定压力。重复的推-拉技术使结肠镜能够沿着小肠推进。
34 例儿童（52.9%为男孩，平均年龄 13.7 岁）共进行了 50 次内镜检查（30 例逆行，20 例顺行）。顺行和逆行时的平均最大插入深度（MDI）、使用 NaviAid AB 的推进深度和平均总操作时间分别为 138cm（100-190cm）、81cm（40-120cm）和 12.8 分钟（7.3-19.0 分钟），143cm（100-170cm）、64cm（20-95cm）和 21.9 分钟（13.9-32.0 分钟）。未报告严重或与器械相关的不良事件。
在儿童中使用 NaviAid AB 小肠镜是安全、可行的，可在短时间内评估小肠。
