Performance and safety of motorized spiral enteroscopy: a systematic review and meta-analysis.


Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
05 2023
Historique:
received: 16 10 2022
revised: 11 12 2022
accepted: 28 01 2023
medline: 21 4 2023
pubmed: 5 2 2023
entrez: 4 2 2023
Statut: ppublish

Résumé

The introduction of motorized spiral enteroscopy (mSE) into clinical practice holds diagnostic and therapeutic potential for small-bowel investigations. This systematic review and meta-analysis aims to evaluate the performance of this modality in diagnosing and treating small-bowel lesions. A systematic search of MEDLINE, Cochrane, and ClinicalTrials.gov databases were performed through September 2022. The primary outcome was diagnostic success, defined as the identification of a lesion relative to the indication. Secondary outcomes were successful therapeutic manipulation, total enteroscopy rate (examination from the duodenojejunal flexion to the cecum), technical success (passage from the ligament of Treitz or ileocecal valve for anterograde and retrograde approach, respectively), and adverse event rates. We performed meta-analyses using a random-effects model, and the results are reported as percentages with 95% confidence intervals (CIs). From 2016 to 2022, 9 studies (959 patients; 42% women; mean age >45 years; 474 patients [49.4%] investigated for mid-GI bleeding/anemia) were considered eligible and included in analysis. The diagnostic success rate of mSE was 78% (95% CI, 72-84; I mSE provides high rates of diagnostic and therapeutic success with a low prevalence of severe adverse events.

Sections du résumé

BACKGROUND AND AIMS
The introduction of motorized spiral enteroscopy (mSE) into clinical practice holds diagnostic and therapeutic potential for small-bowel investigations. This systematic review and meta-analysis aims to evaluate the performance of this modality in diagnosing and treating small-bowel lesions.
METHODS
A systematic search of MEDLINE, Cochrane, and ClinicalTrials.gov databases were performed through September 2022. The primary outcome was diagnostic success, defined as the identification of a lesion relative to the indication. Secondary outcomes were successful therapeutic manipulation, total enteroscopy rate (examination from the duodenojejunal flexion to the cecum), technical success (passage from the ligament of Treitz or ileocecal valve for anterograde and retrograde approach, respectively), and adverse event rates. We performed meta-analyses using a random-effects model, and the results are reported as percentages with 95% confidence intervals (CIs).
RESULTS
From 2016 to 2022, 9 studies (959 patients; 42% women; mean age >45 years; 474 patients [49.4%] investigated for mid-GI bleeding/anemia) were considered eligible and included in analysis. The diagnostic success rate of mSE was 78% (95% CI, 72-84; I
CONCLUSIONS
mSE provides high rates of diagnostic and therapeutic success with a low prevalence of severe adverse events.

Identifiants

pubmed: 36738795
pii: S0016-5107(23)00087-1
doi: 10.1016/j.gie.2023.01.048
pii:
doi:

Types de publication

Meta-Analysis Systematic Review Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

849-858.e5

Informations de copyright

Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Auteurs

Apostolis Papaefthymiou (A)

Pancreaticobiliary Medicine Unit, University College London Hospitals (UCLH), London, UK; First Department of Pharmacology, Medical School, Aristotle University of Thessaloniki, Macedonia, Greece.

Daryl Ramai (D)

Department of Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, Utah, USA.

Marcello Maida (M)

Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, Caltanissetta, Italy.

Georgios Tziatzios (G)

Department of Gastroenterology, General Hospital of Nea Ionia "Konstantopoulio-Patision," Athens, Greece.

Michael Fernandez Y Viesca (MFY)

Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, ULB, Brussels, Belgium.

Ioannis Papanikolaou (I)

Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece.

Konstantina Paraskeva (K)

Department of Gastroenterology, General Hospital of Nea Ionia "Konstantopoulio-Patision," Athens, Greece.

Konstantinos Triantafyllou (K)

Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece.

Alessandro Repici (A)

Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy.

Cesare Hassan (C)

Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy.

Cecilia Binda (C)

Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Italy.

Torsten Beyna (T)

Department of Internal Medicine, Evagelisches Krankenhaus Düsseldorf, Düsseldorf, Germany.

Antonio Facciorusso (A)

Gastroenterology Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy.

Marianna Arvanitakis (M)

Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, ULB, Brussels, Belgium.

Paraskevas Gkolfakis (P)

Department of Gastroenterology, General Hospital of Nea Ionia "Konstantopoulio-Patision," Athens, Greece; Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, ULB, Brussels, Belgium.

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