Published in:
Open Access
14-09-2022 | Other Abdominal Surgery | Original Article
Motorized Spiral Enteroscopy Is Effective in Patients with Prior Abdominal Surgery
Authors:
Antonio Giordano, Gherzon Casanova, Miriam Escapa, Gloria Fernández-Esparrach, Àngels Ginès, Oriol Sendino, Isis K. Araujo, Andrés Cárdenas, Henry Córdova, Julia Martínez-Ocon, Graciela Martínez-Palli, Francesc Balaguer, Josep Llach, Elena Ricart, Begoña González-Suárez
Published in:
Digestive Diseases and Sciences
|
Issue 4/2023
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Abstract
Background
Motorized Spiral Enteroscopy (MSE) reduces procedure time and increases insertion depth into the small bowel; however, there is scarce evidence on factors affecting MSE efficacy.
Aims
To evaluate diagnostic yield and adverse events of MSE including patients with prior major abdominal surgery.
Methods
A prospective observational study was conducted on patients undergoing MSE from June 2019 to December 2021. Demographic characteristics, procedure time, depth of maximum insertion (DMI), technical success, diagnostic yield, and adverse events were collected.
Results
Seventy-four anterograde (54.4%) and 62 retrograde (45.6%) enteroscopies were performed in 117 patients (64 males, median age 67 years). Fifty patients (42.7%) had prior major abdominal surgery. Technical success was 91.9% for anterograde and 90.3% for retrograde route. Diagnostic yield was 71.6% and 61.3%, respectively. The median DMI was 415 cm (264–585) for anterograde and 120 cm (37–225) for retrograde enteroscopy. In patients with prior major abdominal surgery, MSE showed significantly longer small bowel insertion time (38 vs 29 min, p = 0.004), with similar diagnostic yield (61 vs 71.4%, p = 0.201) and DMI (315 vs 204 cm, p = 0.226). The overall adverse event rate was 10.3% (SAE 1.5%), with no differences related to prior abdominal surgery (p = 0.598). Patients with prior surgeries directly involving the gastrointestinal tract showed lower DMI (189 vs 374 cm, p = 0.019) with equal exploration time (37.5 vs 38 min, p = 0.642) compared to those with other abdominal surgeries.
Conclusions
MSE is effective and safe in patients with major abdominal surgery, although longer procedure times were observed. A lower depth of insertion was detected in patients with gastrointestinal surgery.