Gut Liver.  2021 May;15(3):375-382. 10.5009/gnl20023.

Enteroscopy in Crohn’s Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study

Affiliations
  • 1Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
  • 4Department of Internal Medicine, Hallym University College of Medicine, Hwaseong, Korea.
  • 5Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea.
  • 8Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
  • 9Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea.
  • 10Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.

Abstract

Background/Aims
Although balloon-assisted enteroscopy (BAE) enables endoscopic visualization of small bowel (SB) involvement in Crohn’s disease (CD), there is no data on the changes in outcomes over time. We therefore investigated the changes in BAE use on CD patients over different time periods in terms of its role and clinical outcomes.
Methods
We used a multicenter enteroscopy database to identify CD patients with SB involvement who underwent BAE (131 procedures, 116 patients). We compared BAE-related factors and outcomes between the first period (70 procedures, 60 patients) and the second period (61procedures, 56 patients). The specific cutoff point for dividing the two periods was 2007, when BAE guidelines were introduced.
Results
Initial diagnosis of SB involvement in CD was the most common indication for BAE during each period (50.0% vs 31.1%, p=0.034). The largest change was in the number of BAE uses for stricture evaluation and/or treatment, which increased significantly in the latter period (2.9% vs 21.3%, p=0.002). The diagnostic yield in patients with suspected CD was 90.7% in the first period and 95.0% in the second (p=0.695). More endoscopic interventions were performed in the second period than in the first (5.1% vs 17.6%, p=0.041). Enteroscopic success rates were high throughout (100% in the first period vs 80.0% in the second period, p>0.999). In the first and second periods, therapeutic plans were adjusted in 62.7% and 61.4% of patients, respectively.
Conclusions
The overall clinical indications, outcomes, and effectiveness of BAE were constant over time in CD patients with SB involvement, with the exception that the frequency of enteroscopic intervention increased remarkably.

Keyword

Balloon-assisted enteroscopy; Crohn disease; Small bowel; Time; Outcome
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