Spiral enteroscopy versus single-balloon enteroscopy for the evaluation and treatment of small bowel disorders: a systematic review and meta-analysis.

Background/aims: Device-assisted enteroscopy has advanced small bowel disorder management. We conducted this meta-analysis to compare the clinical and procedural outcomes between spiral enteroscopy and single-balloon enteroscopy.

Methods: A systematic search was performed on December 1, 2024, in the PubMed, Scopus, and Cochrane Library databases to identify studies that compared spiral enteroscopy and single-balloon enteroscopy. The outcomes included diagnostic and therapeutic yields, total procedure time, depth of maximum insertion, and adverse event rates.

Results: Five studies (including 496 patients) met the inclusion criteria. The diagnostic yield was similar between spiral enteroscopy and single-balloon enteroscopy (risk ratio [RR], 1.07; 95% confidence interval [CI], 0.96-1.20; p=0.24). The therapeutic yield also showed no significant difference (RR, 1.10; 95% CI, 0.45-2.69; p=0.83). The total procedure time was comparable (mean difference, -22.85 minutes; 95% CI, -46.83 to 1.12; p=0.06), although motorized spiral enteroscopy reduced the procedure time (p<0.001). Spiral enteroscopy achieved greater depth of maximum insertion (standardized mean difference, 1.33; 95% CI, 0.65-2.01; p<0.001). Adverse event rates were comparable (RR, 1.72; 95% CI, 0.80-3.70; p=0.16).

Conclusions: Spiral and single-balloon enteroscopies demonstrated similar diagnostic and therapeutic yields and safety. Spiral enteroscopy achieved a greater insertion depth, and motorized systems improved the efficiency in terms of procedure times.