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Efficacy of Novel Ultrathin Single-Balloon Enteroscopy for Crohn’s Disease: A Propensity Score-Matched Study

Gut and Liver 2020년 14권 5호 p.619 ~ 625
Takabayashi Kaoru, Hosoe Naoki, Kato Motohiko, Hayashi Yukie, Miyanaga Ryoichi, Nanki Kosaku, Fukuhara Kayoko, Mikami Yohei, Mizuno Shinta, Sujino Tomohisa,
소속 상세정보
 ( Takabayashi Kaoru ) - Keio University School of Medicine Center for Diagnostic and Therapeutic Endoscopy
 ( Hosoe Naoki ) - Keio University School of Medicine Center for Diagnostic and Therapeutic Endoscopy
 ( Kato Motohiko ) - Keio University School of Medicine Division of Gastroenterology and Hepatology
 ( Hayashi Yukie ) - Keio University School of Medicine Center for Diagnostic and Therapeutic Endoscopy
 ( Miyanaga Ryoichi ) - Keio University School of Medicine Center for Diagnostic and Therapeutic Endoscopy
 ( Nanki Kosaku ) - Keio University School of Medicine Division of Gastroenterology and Hepatology
 ( Fukuhara Kayoko ) - Keio University School of Medicine Center for Diagnostic and Therapeutic Endoscopy
 ( Mikami Yohei ) - Keio University School of Medicine Division of Gastroenterology and Hepatology
 ( Mizuno Shinta ) - Keio University School of Medicine Division of Gastroenterology and Hepatology
 ( Sujino Tomohisa ) - Keio University School of Medicine Division of Gastroenterology and Hepatology

Abstract


Background/Aims: The evaluation of small bowel lesions of Crohn’s disease (CD) using balloon-assisted enteroscopy (BAE) is crucial because mucosal healing is associated with a good prognosis. However, BAE procedures are invasive, requiring sedation or analgesia to reduce the patient’s pain. This study evaluated the clinical usefulness of a novel ultrathin single-balloon enteroscopy (SBE) procedure for CD.

Methods: This single-center retrospective study included 102 CD patients who underwent trans-anal SBE between January 2012 and May 2018. Of these patients, 82 underwent enteroscopy using conventional SBE, while 20 underwent ultrathin SBE. Patients were analyzed using propensity score matching, with 20 patients per group. The median duration of the examination, terminal ileum intubation rate, median cecum intubation time, median insertion depth, adverse events, and sedated dose in each group were compared.

Results: Before propensity score matching, the conventional SBE group had a larger number of surgical history patients than the ultrathin SBE group (p=0.05). After matching, the two groups did not significantly differ clinically. There were no significant differences in the mean duration of the examination, cecum intubation time, or terminal ileal intubation rate between ultrathin SBE and conventional SBE. The mean insertion depth of ultrathin SBE tended to be deeper than that of conventional SBE (p=0.09). The use of ultrathin SBE also reduced the sedative dose during needed for enteroscopy compared with conventional SBE (p=0.005).

Conclusions: Novel ultrathin SBE may be less painful for CD patients than conventional SBE.

키워드

Enteroscopy; Single-balloon enteroscopy; Ultrathin scope; Crohn disease

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