Gut Liver.  2020 Sep;14(5):619-625. 10.5009/gnl19228.

Efficacy of Novel Ultrathin Single-Balloon Enteroscopy for Crohn’s Disease: A Propensity Score-Matched Study

Affiliations
  • 1Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
  • 2Division of Gastroenterology and Hepatology, Keio University School of Medicine, Tokyo, Japan
  • 3Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

Abstract

Background/Aims
The evaluation of small bowel lesions of Crohn’s disease (CD) using balloon-assisted enteroscopy (BAE) is crucial because mucosal healing is associated with a good prognosis. However, BAE procedures are invasive, requiring sedation or analgesia to reduce the patient’s pain. This study evaluated the clinical usefulness of a novel ul-trathin single-balloon enteroscopy (SBE) procedure for CD.
Methods
This single-center retrospective study included 102 CD patients who underwent trans-anal SBE between Janu-ary 2012 and May 2018. Of these patients, 82 underwent enteroscopy using conventional SBE, while 20 underwent ultrathin SBE. Patients were analyzed using propensity score matching, with 20 patients per group. The median duration of the examination, terminal ileum intubation rate, median cecum intubation time, median insertion depth, adverse events, and sedated dose in each group were compared.
Results
Before propensity score matching, the conventional SBE group had a larger number of surgical history patients than the ultrathin SBE group (p=0.05). After matching, the two groups did not significantly differ clinically. There were no significant differences in the mean duration of the examina-tion, cecum intubation time, or terminal ileal intubation rate between ultrathin SBE and conventional SBE. The mean in-sertion depth of ultrathin SBE tended to be deeper than that of conventional SBE (p=0.09). The use of ultrathin SBE also reduced the sedative dose during needed for enteroscopy compared with conventional SBE (p=0.005).
Conclusions
Novel ultrathin SBE may be less painful for CD patients than conventional SBE.

Keyword

Enteroscopy; Single-balloon enteroscopy; Ultra- thin scope; Crohn disease
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