Matilde Topa, Nicoletta Nandi, Lucia Scaramella, Michele Puricelli, Marco Pennazio, Reena Sidhu, David S Sanders, Gian Eugenio Tontini, Roberto Penagini, Maurizio Vecchi, Luca Elli
{"title":"视频胶囊内窥镜和器械辅助小肠镜在非出血性小肠病变中的临床应用。","authors":"Matilde Topa, Nicoletta Nandi, Lucia Scaramella, Michele Puricelli, Marco Pennazio, Reena Sidhu, David S Sanders, Gian Eugenio Tontini, Roberto Penagini, Maurizio Vecchi, Luca Elli","doi":"10.1177/17562848231176424","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) are part of the diagnostic and therapeutic work-up of indications other than suspected small bowel bleeding (OSBB). The literature is currently lacking studies describing these procedures in this particular setting.</p><p><strong>Objectives: </strong>We assessed the clinical impact of VCE and DBE in a large monocentric cohort of OSBB patients, as compared to a control group of suspected small bowel bleeding (SSBB) patients who underwent enteroscopy over the same period.</p><p><strong>Design: </strong>Monocentric, retrospective, cohort study.</p><p><strong>Methods: </strong>We collected the data of consecutive patients with OSBB undergoing VCE and/or DBE from March 2001 to July 2020. The demographic and clinical parameters of the patients, technical characteristics, and adverse events for each procedure were collected. The impact of VCE and DBE was defined in terms of diagnostic yield (DY). The patients were subdivided according to the main indication into four groups: celiac disease, Crohn's disease (CD), neoplasia, and persistent gastrointestinal symptoms.</p><p><strong>Results: </strong>A total of 611 VCEs and 387 DBEs were performed for OSBB. The main indications were complicated celiac disease and CD. The DYs of VCE and DBE overall were 53 and 61.7%, respectively, with some variance among the four groups. We report no statistical differences in the DY of VCE and DBE in SSBB vs OSBB (57.7% vs 53%, <i>p</i> = 0.0859 and 68.8% vs 61.7%, <i>p</i> = 0.0582, respectively). OSBB patients were significantly younger than those with SSBB. However, similarly to SSBB (<i>k</i> = 0.059), poor agreement between the enteroscopic techniques was found in the OSBB population (<i>k</i> = 0.109). The safety of both procedures in OSBB was comparable to that in SSBB patients.</p><p><strong>Conclusion: </strong>VCE and DBE are effective and safe in suspected OSBB, where their role is similar to that in SSBB, their main indication.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231176424"},"PeriodicalIF":4.2000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/34/10.1177_17562848231176424.PMC10331340.pdf","citationCount":"0","resultStr":"{\"title\":\"Clinical impact of videocapsule endoscopy and device-assisted enteroscopy in non-bleeding small bowel lesions.\",\"authors\":\"Matilde Topa, Nicoletta Nandi, Lucia Scaramella, Michele Puricelli, Marco Pennazio, Reena Sidhu, David S Sanders, Gian Eugenio Tontini, Roberto Penagini, Maurizio Vecchi, Luca Elli\",\"doi\":\"10.1177/17562848231176424\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) are part of the diagnostic and therapeutic work-up of indications other than suspected small bowel bleeding (OSBB). The literature is currently lacking studies describing these procedures in this particular setting.</p><p><strong>Objectives: </strong>We assessed the clinical impact of VCE and DBE in a large monocentric cohort of OSBB patients, as compared to a control group of suspected small bowel bleeding (SSBB) patients who underwent enteroscopy over the same period.</p><p><strong>Design: </strong>Monocentric, retrospective, cohort study.</p><p><strong>Methods: </strong>We collected the data of consecutive patients with OSBB undergoing VCE and/or DBE from March 2001 to July 2020. The demographic and clinical parameters of the patients, technical characteristics, and adverse events for each procedure were collected. The impact of VCE and DBE was defined in terms of diagnostic yield (DY). The patients were subdivided according to the main indication into four groups: celiac disease, Crohn's disease (CD), neoplasia, and persistent gastrointestinal symptoms.</p><p><strong>Results: </strong>A total of 611 VCEs and 387 DBEs were performed for OSBB. The main indications were complicated celiac disease and CD. The DYs of VCE and DBE overall were 53 and 61.7%, respectively, with some variance among the four groups. We report no statistical differences in the DY of VCE and DBE in SSBB vs OSBB (57.7% vs 53%, <i>p</i> = 0.0859 and 68.8% vs 61.7%, <i>p</i> = 0.0582, respectively). OSBB patients were significantly younger than those with SSBB. However, similarly to SSBB (<i>k</i> = 0.059), poor agreement between the enteroscopic techniques was found in the OSBB population (<i>k</i> = 0.109). 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Clinical impact of videocapsule endoscopy and device-assisted enteroscopy in non-bleeding small bowel lesions.
Background: Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) are part of the diagnostic and therapeutic work-up of indications other than suspected small bowel bleeding (OSBB). The literature is currently lacking studies describing these procedures in this particular setting.
Objectives: We assessed the clinical impact of VCE and DBE in a large monocentric cohort of OSBB patients, as compared to a control group of suspected small bowel bleeding (SSBB) patients who underwent enteroscopy over the same period.
Design: Monocentric, retrospective, cohort study.
Methods: We collected the data of consecutive patients with OSBB undergoing VCE and/or DBE from March 2001 to July 2020. The demographic and clinical parameters of the patients, technical characteristics, and adverse events for each procedure were collected. The impact of VCE and DBE was defined in terms of diagnostic yield (DY). The patients were subdivided according to the main indication into four groups: celiac disease, Crohn's disease (CD), neoplasia, and persistent gastrointestinal symptoms.
Results: A total of 611 VCEs and 387 DBEs were performed for OSBB. The main indications were complicated celiac disease and CD. The DYs of VCE and DBE overall were 53 and 61.7%, respectively, with some variance among the four groups. We report no statistical differences in the DY of VCE and DBE in SSBB vs OSBB (57.7% vs 53%, p = 0.0859 and 68.8% vs 61.7%, p = 0.0582, respectively). OSBB patients were significantly younger than those with SSBB. However, similarly to SSBB (k = 0.059), poor agreement between the enteroscopic techniques was found in the OSBB population (k = 0.109). The safety of both procedures in OSBB was comparable to that in SSBB patients.
Conclusion: VCE and DBE are effective and safe in suspected OSBB, where their role is similar to that in SSBB, their main indication.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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