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A meta-analysis on efficacy and safety: single-balloon vs. double-balloon enteroscopy
Vaibhav Wadhwa1, Saurabh Sethi2, Sumeet Tewani2
1Department of Internal Medicine, Fairview Hospital, Cleveland Clinic, Cleveland, OH, USA, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA and Division of Basic and Translational Research, Department of Surgery, University of Minnesota, Minneapolis, MN, USA wadhwav@ccf.org.
Double-balloon enteroscopy (DBE) offers superior complete small bowel visualization compared to single-balloon enteroscopy (SBE). However, both methods show similar diagnostic and therapeutic yields, with comparable complication rates.
Area of Science:
- Gastroenterology
- Endoscopy
- Medical Technology Evaluation
Background:
- Deep enteroscopy is crucial for small bowel evaluation.
- Double-balloon enteroscopy (DBE) and single-balloon enteroscopy (SBE) are advanced techniques for deep enteroscopy.
- Previous studies have not definitively established the superiority of either DBE or SBE.
Purpose of the Study:
- To systematically compare the efficacy and safety of DBE versus SBE for small bowel evaluation.
- To pool data from available studies to identify the optimal enteroscopy technique.
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and the Cochrane Central Register of Controlled Trials.
- Key outcome measures included complete small-bowel visualization, diagnostic yield, therapeutic yield, and complication rates.
- Meta-analysis was performed on data from four prospective, randomized, controlled trials involving 375 patients.
Main Results:
- Double-balloon enteroscopy (DBE) demonstrated superior complete small bowel visualization compared to single-balloon enteroscopy (SBE) (RR = 0.37, P = 0.004).
- Both DBE and SBE exhibited similar diagnostic yields (RR = 0.95, P = 0.62), therapeutic yields (RR = 0.78, P = 0.09), and complication rates (RR = 1.08, P = 0.91).
Conclusions:
- DBE is more effective than SBE for achieving complete visualization of the small bowel.
- Despite DBE's advantage in visualization, diagnostic and therapeutic yields, along with complication rates, were comparable between the two methods.
- The findings, based on a limited number of studies and small sample sizes, suggest low to moderate evidence quality.
