Role of novel motorized spiral enteroscopy in the evaluation of small bowel diseases: A systematic review and meta-analysis

Aims Motorized spiral enteroscopy (MSE) has been recently introduced for small bowel evaluation. In this systematic review and meta-analysis, we aim to analyze the performance of MSE for evaluation of small bowel diseases.

Methods Literature search was performed in Embase, PubMed, Cochrane database between Jan-2010 to Oct-2022. Primary outcome was diagnostic yield. Secondary outcomes included technical success, procedure duration, depth of maximum insertion (DMI), pan-enteroscopy rates and adverse events.

Results 10 studies with 961 patients [581 (60.5%) males] were included in analysis. 1,068 MSE procedures were performed, by antegrade route in 698, retrograde route in 215 and combined routes in 155 cases. Technical success was achieved in 94.9% (95% CI 92.9%-96.4%; I ² =16%) procedures. Pooled diagnostic yield was 73.7% (95% CI 70.7% to 76.4%; I ² =78%) (Table 1). Pooled mean DMI by antegrade and retrograde routes were 383.6 (95% CI 371.2 to 396.1; I ² =64%) cm and 141.4 (95% CI 129.5 to 153.3; I ² =67%) cm, respectively. Pan-enteroscopy rate by combined route was 61.2% (95%CI 52.4%-69.3%; I ² =33%).Pooled rate of major adverse events was 1.9% (95% CI 1.2%-3.2%; I ² =0%).

Conclusions MSE is a safe and effective tool for evaluation of small bowel disorders. High diagnostic yield and low rate of adverse events make it a potential alternative to balloon enteroscopy ([Table 1]).

Table 1  Forrest plot showing pooled diagnostic yield of motorized spiral enteroscopy for small bowel diseases.

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Artikel online veröffentlicht:
14. April 2023