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

• Jeon SR
• Kim JO
• Byeon JS
• Yang DH
• Ko BM
• Goong HJ
• Jang HJ
• Park SJ
• Kim ER
• Hong SN
• Im JP
• Kim SE
• Koo JS
• Eun CS
• Chang DK
• Small Intestine Research Group of the Korean Association for the Study of Intestinal Diseases (KASID)

• KMID: 2515841
• DOI: http://doi.org/10.5009/gnl20023

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