Spiral enteroscopy: prospective U.S. multicenter study in patients with small-bowel disorders

Area of Science:

• Gastroenterology
• Endoscopy
• Small Bowel Imaging

Background:

• The clinical utility and performance metrics of spiral enteroscopy remain underexplored.
• Previous research has not comprehensively detailed its technical capabilities and outcomes.

Purpose of the Study:

• To assess the technical performance, diagnostic accuracy, therapeutic efficacy, and safety of oral spiral enteroscopy.
• To evaluate spiral enteroscopy in patients with suspected or confirmed small bowel conditions.

Main Methods:

• A prospective, multicenter cohort study was conducted across ten U.S. tertiary-care centers.
• 148 participants underwent spiral enteroscopy, with a focus on 101 patients referred for obscure gastrointestinal bleeding.
• Key outcome measures included procedure duration, insertion depth, diagnostic findings, and therapeutic interventions.

Main Results:

• Spiral enteroscopy achieved a 93% success rate with a median insertion depth of 250 cm beyond the Treitz angle.
• The diagnostic yield was 65%, identifying angiectasias (61.5%), inflammation (7.5%), and neoplasia (6.8%) as common findings.
• Therapeutic interventions, primarily argon plasma coagulation ablation (64%), were successfully performed.

Conclusions:

• Spiral enteroscopy demonstrates safety and efficacy for small bowel examination.
• Its procedural efficiency, insertion depth, and diagnostic/therapeutic yields are comparable to single- and double-balloon enteroscopy.
• Further comparative studies are recommended to solidify its position among deep enteroscopy techniques.