电动螺旋式小肠镜：用于新适应证时的有效性。

Motorized spiral enteroscopy: effectiveness when used for new indications.

机构信息

Cliniques universitaires Saint-Luc, Gastroenterology and Hepatology, Brussels, Belgium.

Centre hospitalier universitaire (UCL) Namur site Godinne, Gastroenterology and Hepatology, Yvoir, Belgium.

出版信息

Acta Gastroenterol Belg. 2023 Apr-Jun;86(2):269-275. doi: 10.51821/86.2.11779.

DOI:10.51821/86.2.11779

PMID:37428159

Abstract

BACKGROUND AND STUDY AIMS

Motorized spiral enteroscopy is proven to be effective in antegrade and retrograde enteroscopy. Nevertheless, little is known about its use in less common indications. The aim of this study was to identify new indications for the motorized spiral enteroscope.

METHODS

Monocentric retrospective analysis of 115 patients who underwent enteroscopy using PSF-1 motorized spiral enteroscope between January 2020 and December 2022.

RESULTS

A total of 115 patients underwent PSF-1 enteroscopy. 44 (38%) were antegrade procedures and 24 (21%) were retrograde procedures in patients with normal gastrointestinal anatomy with conventional enteroscopy indications. The remaining 47 (41%) patients underwent PSF-1 procedures for secondary less conventional indications: n=25 (22%) enteroscopy-assisted ERCP, n=8 (7%) endoscopy of the excluded stomach after Roux-en-Y gastric bypass, n=7 (6%) retrograde enteroscopy after previous incomplete conventional colonoscopy and n=7 (6%) antegrade panenteroscopy of the entire small bowel. In this group of secondary indications, technical success rate was significantly lower (72.5%) as compared to technical success rates in the conventional groups (98-100%, p<0.001 Chi-square). Minor adverse events occurred in 17/115 patients (15%), all treated conservatively (AGREE I and II).

CONCLUSION

This study demonstrates the capabilities of PSF-1 motorized spiral enteroscope for secondary indications. PSF-1 is useful to complete colonoscopy in case of long redundant colon, to reach the excluded stomach after Roux-en-Y gastric bypass, to perform unidirectional pan-enteroscopy and to perform ERCP in patients with surgically altered anatomy. However, technical success rates are lower as compared to conventional antegrade and retrograde enteroscopy procedures, with only minor adverse events.

摘要

背景和研究目的

电动螺旋内窥镜在经口和经肛内镜逆行胆胰管造影术（ERCP）中已被证实有效。然而，对于其在不太常见适应证中的应用知之甚少。本研究旨在确定电动螺旋内窥镜的新适应证。

方法

对 2020 年 1 月至 2022 年 12 月期间使用 PSF-1 型电动螺旋内窥镜进行内镜检查的 115 例患者进行单中心回顾性分析。

结果

共有 115 例患者接受了 PSF-1 型内窥镜检查。44 例（38%）为经口逆行性手术，24 例（21%）为经肛逆行性手术，这些患者的胃肠道解剖结构正常，具有常规内窥镜检查适应证。其余 47 例（41%）患者因次要的非传统适应证接受 PSF-1 手术：n=25 例（22%）为内镜辅助逆行胰胆管造影术（ERCP），n=8 例（7%）为 Roux-en-Y 胃旁路术后排除胃的内镜检查，n=7 例（6%）为之前不完全常规结肠镜检查后的逆行性内镜检查，n=7 例（6%）为整个小肠的经口顺行全小肠镜检查。在这组次要适应证中，技术成功率明显低于常规组（98-100%，p<0.001 卡方检验）（72.5%）。115 例患者中有 17 例（15%）出现轻微不良事件，均予保守治疗（AGREE I 和 II）。