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CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(10): E1184-E1189
DOI: 10.1055/a-0650-4168
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Insertability comparison of passive bending single-balloon prototype versus standard single-balloon enteroscopy: a multicenter randomized non-blinded trial

Naoki Hosoe
1   Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan
,
Kazuo Ohtsuka
2   Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
3   Departments of Endoscopy, Tokyo Medical and Dental University, Tokyo, Japan apan
,
Yutaka Endo
4   Center for Gastroenterology and Inflammatory Bowel Disease, Ofuna Chuo Hospital, Kamakura, Japan
,
Makoto Naganuma
5   Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
,
Noriyuki Ogata
2   Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Yuichiro Kuroki
6   Department of Gastroenterology, Fujigaoka Hospital, Showa University, Yokohama, Japan
,
Seiko Sasanuma
2   Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Kaoru Takabayashi
1   Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan
,
Shin-Ei Kudo
2   Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Hiroshi Takahashi
6   Department of Gastroenterology, Fujigaoka Hospital, Showa University, Yokohama, Japan
,
Haruhiko Ogata
1   Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan
,
Takanori Kanai
5   Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
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Publikationsverlauf

submitted 01. Januar 2018

accepted after revision 09. Mai 2018

Publikationsdatum:
08. Oktober 2018 (online)

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Abstract

Background and study aims Traversing the ileocecal valve (ICV) is technically challenging with a retrograde approach to single-balloon enteroscopy (SBE). A novel technique called responsive insertion technology (RIT) colonoscopy was developed to obtain a higher cecal intubation rate in this setting. A prototype long SBE equipped with RIT (P-SBE) was developed to obtain superior insertability. The aim of this study was to compare the insertability of a standard single-balloon enteroscope (S-SBE) versus a P-SBE.

Patients and methods This study was a multicenter, randomized, non-blinded, trial of 62 patients with small bowel pathologies. All procedures were performed with SBE via the trans-anal route. Procedure success was defined as stable intubation of the terminal ileum (TI) 20 cm beyond the ICV. The primary variable was time to reach stable TI intubation 20 cm beyond the ICV (TSTII). If stable TI intubation was not achieved within 10 minutes, the initial SBE was removed through the indwelling overtube and replaced with another SBE.

Results Sixty patients were examined with two patients excluded from this study. TSTII using P-SBE was significantly decreased compared to S-SBE (mean P-SBE vs S-SBE: 98.3 vs 169.4 second, P = 0.006). The completion rates for stable intubation within 10 minutes of using P-SBE and S-SBE were 96.8 % and 86.2 %, respectively (P = 0.19). On endoscope replacement, all patients had achieved stable TI intubation.

Conclusions SBE with RIT improves insertability when traversing the ileocecal valve in retrograde SBE.

 

  • References

  • 1 Yamamoto H, Sekine Y, Sato Y. et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc 2001; 53: 216-220
    CrossrefPubMedSuche in Google Scholar
  • 2 Ohtsuka K, Kashida H, Kodama K. et al. Diagnosis and treatment of small bowel diseases with a newly developed single balloon endoscope. Dig Endosc 2008; 20: 134-137
    CrossrefPubMedSuche in Google Scholar
  • 3 Tsujikawa T, Saitoh Y, Andoh A. et al. Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine: preliminary experiences. Endoscopy 2008; 40: 11-15
    Thieme ConnectPubMedSuche in Google Scholar
  • 4 Manno M, Barbera C, Bertani H. et al. Single balloon enteroscopy: Technical aspects and clinical applications. World J Gastrointest Endosc 2012; 4: 28-32
    CrossrefPubMedSuche in Google Scholar
  • 5 Mehdizadeh S, Han NJ, Cheng DW. et al. Success rate of retrograde double-balloon enteroscopy. Gastrointest Endosc 2007; 65: 633-639
    CrossrefPubMedSuche in Google Scholar
  • 6 Saito Y, Kimura H. Responsive insertion technology. Dig Endosc 2011; 23 (Suppl. 01) 164-167
    CrossrefPubMedSuche in Google Scholar
  • 7 Hoff G, Bretthauer M, Huppertz-Hauss G. et al. Evaluation of a novel colonoscope designed for easier passage through flexures: a randomized study. Endoscopy 2005; 37: 1123-1126
    Thieme ConnectPubMedSuche in Google Scholar
  • 8 Sato K, Ito S, Shigiyama F. et al. A prospective randomized study on the benefits of a new small-caliber colonoscope. Endoscopy 2012; 44: 746-753
    Thieme ConnectPubMedSuche in Google Scholar
  • 9 Sato K, Shigiyama F, Ito S. et al. Colonoscopy using a small-caliber colonoscope with passive-bending after incomplete colonoscopy due to sharp angulation or pain. Surg Endosc 2013; 27: 4171-4176
    CrossrefPubMedSuche in Google Scholar
  • 10 Prieto-de-Frias C, Munoz-Navas M, Carretero C. et al. Comparative study of a responsive insertion technology (RIT) colonoscope ersus a variable-stiffness colonoscope. Rev Esp Enferm Dig 2013; 105: 208-213
    CrossrefPubMedSuche in Google Scholar
  • 11 Garborg KK, Loberg M, Matre J. et al. Reduced pain during screening colonoscopy with an ultrathin colonoscope: a randomized controlled trial. Endoscopy 2012; 44: 740-746
    Thieme ConnectPubMedSuche in Google Scholar
  • 12 Yamauchi H, Kida M, Okuwaki K. et al. Passive-bending, short-type single-balloon enteroscope for endoscopic retrograde cholangiopancreatography in Roux-en-Y anastomosis patients. World J Gastroenterol 2015; 21: 1546-1553
    CrossrefPubMedSuche in Google Scholar
  • 13 Shimatani M, Takaoka M, Ikeura T. et al. Evaluation of endoscopic retrograde cholangiopancreatography using a newly developed short-type single-balloon endoscope in patients with altered gastrointestinal anatomy. Dig Endosc 2014; 26 (Suppl. 02) 147-155
    CrossrefPubMedSuche in Google Scholar
  • 14 Han S, Bhattacharya K, Cave DR. Preliminary colonoscopy facilitates retrograde double-balloon enteroscopy. Endosc Int Open 2014; 2: E241
    Thieme ConnectPubMedSuche in Google Scholar
  • 15 Christian KE, Kapoor K, Goldberg EM. Performance characteristics of retrograde single-balloon endoscopy: A single center experience. World J Gastrointest Endosc 2016; 8: 501-507
    CrossrefPubMedSuche in Google Scholar
  • 16 Despott E, Fraser C. Achieving successful ileal intubation during retrograde double balloon enteroscopy: description of a novel, alternative technique (with video). Endoscopy 2009; 41 (Suppl. 02) 309
    Thieme ConnectPubMedSuche in Google Scholar
  • 17 Sugano K, Kita H. Double-balloon endoscopy: theory and practice. Tokyo: Springer; 2006
    CrossrefSuche in Google Scholar
  • 18 Dufault DL, Brock AS. Cap-assisted retrograde single-balloon enteroscopy results in high terminal ileal intubation rate. Endosc Int Open 2016; 4: E202
    Thieme ConnectPubMedSuche in Google Scholar