Multicenter comparison of double-balloon enteroscopy and spiral enteroscopy

Area of Science:

• Gastroenterology
• Endoscopy
• Small Bowel Imaging

Background:

• Small bowel lesions often require advanced imaging techniques.
• Capsule endoscopy is a primary diagnostic tool for suspected small bowel pathology.
• Double-balloon enteroscopy (DBE) and spiral enteroscopy (SE) are advanced endoscopic methods for small bowel exploration.

Purpose of the Study:

• To compare the efficacy and safety of spiral enteroscopy (SE) versus double-balloon enteroscopy (DBE).
• To evaluate diagnostic and therapeutic yields in patients with suspected small bowel lesions.
• To assess procedure duration and length of small bowel explored by each technique.

Main Methods:

• Prospective study including patients diagnosed with small bowel lesions via capsule endoscopy.
• Comparison of 191 double-balloon enteroscopies and 50 spiral enteroscopies performed across five academic medical centers.
• Data collection on lesion detection, procedure time, length of bowel explored, therapeutic interventions, and complications.

Main Results:

• Both DBE and SE detected lesions in 70% and 75% of cases, respectively.
• Procedure times (60 min vs. 55 min) and explored lengths (200 cm vs. 220 cm) were similar, with a slight, non-significant advantage for SE.
• Therapeutic interventions were successful in 66% of DBE and 70% of SE cases, with no significant major complications for either.

Conclusions:

• Spiral enteroscopy (SE) is as safe as double-balloon enteroscopy (DBE) for small bowel exploration.
• SE demonstrates comparable diagnostic and therapeutic yields to DBE.
• While slightly favoring SE, procedural duration and length of exploration were not significantly different between the two enteroscopy methods.