Clinical Outcomes of Double-Balloon Endoscopy for the Diagnosis and Treatment of Small-Intestinal Diseases
Clinical Outcomes of Double-Balloon Endoscopy for the Diagnosis and Treatment of Small-Intestinal Diseases
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DOI：
10.1016/s1542-3565(04)00453-7
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发表时间：
2004-11-01
影响因子：
12.6
通讯作者：
Sugano, Kentaro
中科院分区：
文献类型：
--
作者：
Yamamoto, Hironori;Kita, Hiroto;Sugano, Kentaro
背景与目的：为一种新的肠镜检查方法——双气囊法，研制了一种专门的系统。本研究的目的是评估该内镜系统对小肠疾病的有用性。方法：采用双球囊内镜系统对123例患者行178例内镜检查，其中顺行入路89例，逆行入路89例。该系统是根据空肠和回肠插入的成功率以及小肠的整体检查、诊断率、治疗能力和并发症进行评估的。结果：所有178例手术均可将内窥镜置入Treitz韧带或回盲瓣以外。每种方法都可以观察到大约一半到三分之二的整个小肠，28项试验中有24项（86%）可以观察到整个小肠。66例胃肠道出血患者中有50例（76%）确定了出血的来源，23例患者可以检查狭窄，17例患者在内镜下检查了肿瘤。并发症2例（1.1%）。成功实施小肠内镜治疗，包括止血（12例）、息肉切除（1例）、内镜粘膜切除（1例）、球囊扩张（6例）、支架置入术（2例）。结论：双球囊内镜检查小肠的成功率高于全肠镜检查。该方法安全、实用，具有较高的诊断率和治疗能力。
Background & Aims: A specialized system for a new method for enteroscopy, the double-balloon method, was developed. The aim of this study was to evaluate the usefulness of this endoscopic system for small-intestinal disorders. Methods: The double-balloon endoscopy system was used to perform 178 enteroscopies (89 by the anterograde approach and 89 by the retrograde approach) in 123 patients. The system was assessed on the basis of the rates of success in jejunal and ileal insertion and the entire examination of the small intestine, diagnostic yields, ability to perform treatment, and complications. Results: Insertion of the endoscope beyond the ligament of Treitz or ileocecal valve was possible in all 178 procedures. It was possible to observe approximately one half to two thirds of the entire small intestine by each approach, and observation of the entire small intestine was possible in 24 (86%) of 28 trials. The source of bleeding was identified in 50 (76%) of 66 patients with GI bleeding, scrutiny of strictures was possible in 23 patients, and a tumor was examined endoscopically in 17 patients. Two complications (1.1%) occurred. Endoscopic therapies in the small intestine including hemostasis (12 cases), polypectomy (1 case), endoscopic mucosal resection (1 case), balloon dilation (6 cases), and stent placement (2 cases) were performed successfully. Conclusions: Double-balloon endoscopy permits the exploration of the small intestine with a high success rate of total enteroscopy. The procedure is safe and useful, and it provides high diagnostic yields and therapeutic capabilities.