Prospective multicenter study to identify optimal target population for motorized spiral enteroscopy

Area of Science:

• Gastroenterology
• Endoscopy
• Small Bowel Imaging

Background:

• Motorized spiral enteroscopy (MSE) is an advanced technique for small bowel exploration.
• Optimal patient selection for MSE remains unclear, necessitating further investigation into its efficacy and safety across diverse populations.

Purpose of the Study:

• To identify the ideal patient population for MSE by assessing its efficacy and safety.
• To detect predictors of MSE efficacy in various clinical scenarios.

Main Methods:

• A prospective, multicenter observational study involving 294 patients across 9 Spanish tertiary hospitals from June 2020 to June 2022.
• Data collected included patient demographics, procedural indications, exploration time, depth of maximum insertion (DMI), technical success, diagnostic yield, interventional yield, and adverse events (AE).
• Specific analysis focused on patients with prior gastrointestinal surgery, those with unsuccessful balloon enteroscopy, and patients with suspected small bowel strictures.

Main Results:

• MSE achieved 92.2% technical success and a 56.9% diagnostic yield in patients with prior unsuccessful balloon enteroscopy.
• In cases of suspected small bowel strictures, MSE confirmed the finding in 46.9% of procedures.
• Patients with prior gastrointestinal surgery exhibited a lower DMI (162 vs. 275 cm) and diagnostic yield (47.7% vs. 67.5%) compared to those without such history.
• The overall AE rate was 10.7% (1.8% major), with no significant safety differences observed across the analyzed subgroups.

Conclusions:

• MSE is a feasible and safe option for small bowel examination following unsuccessful balloon enteroscopy and in cases of suspected strictures.
• While MSE demonstrates safety in patients with prior gastrointestinal surgery, its diagnostic yield and depth of insertion are reduced in this population.
• Further research may refine patient selection criteria to optimize MSE outcomes.