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Cap-assisted retrograde single-balloon enteroscopy results in high terminal ileal intubation rate

机译:帽辅助逆行单气囊肠镜检查可导致高的回肠末端插管率

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摘要

>Background and study aims: Retrograde single-balloon enteroscopy (RSBE) facilitates evaluation of the distal small bowel and provision of appropriate therapy when necessary. Intubation of the terminal ileum (TI) is a major rate-limiting step, with failure rates as high as 30 %. Cap-assisted endoscopy has proven beneficial in other aspects of endoscopy. We have noticed that it similarly aids in TI intubation during RSBE by facilitating opening of the ileocecal valve (ICV). The primary aim of this study was to measure the TI intubation rate using cap-assisted RSBE. Other procedural details and outcomes were also measured. >Patients and methods: A total of 36 consecutive RSBEs performed between July 2011 and May 2014 at the Medical University of South Carolina were retrospectively reviewed. All procedures were performed or supervised by our center’s small bowel endoscopist (ASB). Outcomes measured included TI intubation rate, procedure time, depth of maximal insertion (DMI), diagnostic yield (DY), therapeutic yield (TY), and complications. >Results: The TI intubation rate was 97 % (35 /36). The one failure was due to stool completely obscuring the cecum. Median procedure time was 54 minutes, with a mean DMI of 68 cm beyond the ICV. The technical success rate was 86 %, whereas DY and TY were 61 % and 25 %, respectively. There were no complications. The study was limited in that it involved a single endoscopist at a single center. >Conclusions: Cap-assisted RSBE results in a high TI intubation rate, without compromise to safety or procedural yield.
机译:>背景和研究目标:逆行单气囊肠镜(RSBE)有助于评估远端小肠并在必要时提供适当的治疗。末端回肠(TI)的插管是主要的限速步骤,失败率高达30%。帽辅助内窥镜在内窥镜的其他方面已被证明是有益的。我们注意到,它通过促进回盲瓣膜(ICV)的打开,类似地有助于RSBE期间的TI插管。这项研究的主要目的是使用帽辅助RSBE测量TI插管率。还测量了其他程序细节和结果。 >患者和方法:回顾性分析了2011年7月至2014年5月间在南卡罗来纳州医科大学进行的36次连续RSBE。所有程序均由我们中心的小肠内镜医师(ASB)执行或监督。测得的结果包括TI插管率,手术时间,最大插入深度(DMI),诊断率(DY),治疗率(TY)和并发症。 >结果: TI插管率为97%(35/36)。一种失败是由于大便完全掩盖了盲肠。中位手术时间为54分钟,平均DMI比ICV高68 cm。技术成功率为86%,而DY和TY分别为61%和25%。没有并发症。该研究的局限性在于它只涉及一个中心的一名内镜医师。 >结论:盖帽辅助的RSBE可实现高TI插管率,而不会影响安全性或手术良率。

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