Rolando Pinho1, Miguel Mascarenhas-Saraiva2, Susana Mão-de-Ferro3, Sara Ferreira3, Nuno Almeida4, Pedro Figueiredo4, Adélia Rodrigues5, Hélder Cardoso6, Margarida Marques6, Bruno Rosa7, José Cotter8, Germano Vilas-Boas9, Carla Cardoso9, Marta Salgado10, Ricardo Marcos-Pinto10. 1. ManopH, Instituto CUF, Portugal; Serviço de Gastrenterologia, Centro Hospitalar de Gaia/Espinho, Portugal. 2. ManopH, Instituto CUF, Portugal. 3. Serviço de Gastrenterologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Portugal. 4. Faculdade de Medicina da Universidade de Coimbra, Portugal; Serviço de Gastrenterologia, Centro Hospitalar e Universitário de Coimbra, Portugal. 5. Serviço de Gastrenterologia, Centro Hospitalar de Gaia/Espinho, Portugal. 6. Serviço de Gastrenterologia, Centro Hospitalar de São João, Portugal. 7. Serviço de Gastrenterologia, Centro Hospitalar do Alto Ave, Portugal. 8. Serviço de Gastrenterologia, Centro Hospitalar do Alto Ave, Portugal; Instituto de Ciências da Vida e Saúde (ICVS), Escola de Ciências da Saúde, Universidade do Minho, Portugal; ICVS/3B's, Laboratório Associado, Braga/Guimarães, Portugal. 9. Serviço de Gastrenterologia, Hospital Pedro Hispano, Portugal. 10. Serviço de Gastrenterologia, Centro Hospitalar do Porto, Portugal.
Abstract
BACKGROUND: Device-assisted enteroscopies (DAEs) are recent endoscopic techniques that enable direct endoscopic small-bowel evaluation. OBJECTIVE: The objective of this article is to evaluate the implementation of DAEs in Portugal and assess the main indications, diagnoses, diagnostic yield, therapeutic yield and complication rate. METHODS: We conducted a multicenter retrospective series using a national Web-based survey on behalf of the Portuguese Small-Bowel Study Group. Participants were asked to fill out two online databases regarding procedural data, indications, diagnoses, endoscopic therapy and complications using prospectively collected institutional data records. RESULTS: A total of eight centers were enrolled in the survey, corresponding to 1411 DAEs. The most frequent indications were obscure gastrointestinal bleeding (OGIB), inflammatory bowel disease and small-bowel tumors. The pooled diagnostic yield was 63%. A relation between the diagnostic yield and the indications was clear, with a diagnostic yield for OGIB of 69% (p = 0.02) with a 52% therapeutic yield. Complications occurred in 1.2%, with a major complication rate of 0.57%. Perforations occurred in four patients (0.28%). CONCLUSION: DAEs are safe and effective procedures, with complication rates of 1.2%, the most serious of which is perforation. Most procedures are performed in the setting of OGIB. Diagnostic and therapeutic yields are dependent on the indication, hence appropriate patient selection is crucial.
BACKGROUND: Device-assisted enteroscopies (DAEs) are recent endoscopic techniques that enable direct endoscopic small-bowel evaluation. OBJECTIVE: The objective of this article is to evaluate the implementation of DAEs in Portugal and assess the main indications, diagnoses, diagnostic yield, therapeutic yield and complication rate. METHODS: We conducted a multicenter retrospective series using a national Web-based survey on behalf of the Portuguese Small-Bowel Study Group. Participants were asked to fill out two online databases regarding procedural data, indications, diagnoses, endoscopic therapy and complications using prospectively collected institutional data records. RESULTS: A total of eight centers were enrolled in the survey, corresponding to 1411 DAEs. The most frequent indications were obscure gastrointestinal bleeding (OGIB), inflammatory bowel disease and small-bowel tumors. The pooled diagnostic yield was 63%. A relation between the diagnostic yield and the indications was clear, with a diagnostic yield for OGIB of 69% (p = 0.02) with a 52% therapeutic yield. Complications occurred in 1.2%, with a major complication rate of 0.57%. Perforations occurred in four patients (0.28%). CONCLUSION:DAEs are safe and effective procedures, with complication rates of 1.2%, the most serious of which is perforation. Most procedures are performed in the setting of OGIB. Diagnostic and therapeutic yields are dependent on the indication, hence appropriate patient selection is crucial.
Authors: Teresa Pinto-Pais; Rolando Pinho; Adélia Rodrigues; Carlos Fernandes; Iolanda Ribeiro; José Fraga; João Carvalho Journal: United European Gastroenterol J Date: 2014-12 Impact factor: 4.623
Authors: Joana Ribeiro da Silva; Rolando Pinho; Adélia Rodrigues; Ana Ponte; Jaime Rodrigues; Mafalda Sousa; João Carvalho Journal: GE Port J Gastroenterol Date: 2018-01-17