Double-balloon enteroscopy in the elderly: safety, findings, and diagnostic and therapeutic success

Hegde, Sanjay R.; Iffrig, Kevan; Li, Tianyu; Downey, Sharon; Heller, Stephen; Tokar, Jeffrey L.; Haluszka, Oleh

doi:10.1016/j.gie.2009.10.054

Cited by 43 publications

(47 citation statements)

References 42 publications

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“…All three older groups had higher therapeutic yields compared with our control group. This is consistent with other studies reporting therapeutic yields of 42-48% in the general population for SBE and is also comparable with a reported therapeutic yield of 46.8% for DBE in the elderly [Frantz et al 2010;Upchurch et al 2010;May et al 2010;Hedge et al 2010].…”

Section: Discussionsupporting

confidence: 93%

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The safety and efficacy of single balloon enteroscopy in the elderly

Davis-Yadley

Lipka

Rodriguez

et al. 2015

Therap Adv Gastroenterol

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Background: Single balloon enteroscopy (SBE) is an important tool in the management of small bowel disease with limited data available on its performance in the elderly. We aimed to evaluate the safety, efficacy, diagnostic and therapeutic outcomes of SBE in the elderly. Methods: A retrospective review was performed on 366 patients undergoing 428 SBEs from 2010 to 2014. Patients were divided into different age groups: control <55, 55-64, 65-74 and ⩾75 years. Data on comorbidities, complications, findings, diagnostic and therapeutic yield were compared between groups. Results: Anterograde and retrograde SBE were performed in 340 and 49 patients, respectively, with 63 patients requiring more than 1 procedure. Diagnostic yield was significantly higher for age ⩾75 years compared with <55, 66.3% versus 50%, odds ratio (OR) 1.97 [95% confidence interval (CI) 1.14-3.41]. Therapeutic yield was significantly higher in all three older age groups compared with <55 years, 20.3%: 55-64 years, 44.4%, OR 3.13(95% CI 1.7-5.78); 65-74 years, 42%, OR 2.84 (95% CI 1.59-5.06); and >75 years, 47.5%, OR 3.55 (95% CI 1.96-6.43). No significant difference was seen between age groups in complications or failures. Our overall complication rate was 2.3% with 5 minor and 5 major complications. There was a higher yield of angioectasias in the elderly. Argon plasma coagulation (APC) and multipolar electrocoagulation were used more often in older age groups. Conclusion: SBE is safe in elderly patients and delivers higher diagnostic and therapeutic yields compared to younger patients. The elderly are more likely to have angioectasias and undergo APC and electrocoagulation.

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Section: Discussionsupporting

confidence: 93%

“…Angioectasias are also more common in the elderly comparable with the data with DBE [Hedge et al 2010;Byeon et al 2012]. With increasing age, there was a progressively higher number of angioectasias with 13.6% in <55 years, 30% in 55-64 years, 37% in 55-74 years and 39.6% in ⩾75 years.…”

Section: Discussionsupporting

confidence: 83%

The safety and efficacy of single balloon enteroscopy in the elderly

Davis-Yadley

Lipka

Rodriguez

et al. 2015

Therap Adv Gastroenterol

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“…First, the diagnostic yield is higher in elderly patients compared with the young, 75.3% vs 58.5% (p=0.016). This is similar to data presented by Hegde et al 36 as well as from this institute,29 although a statistically significant difference was not previously demonstrated. The high diagnostic yield in the elderly is also in keeping with previously quoted figures.…”

Section: Discussionsupporting

confidence: 92%

Paradigm shift: should the elderly undergo propofol sedation for DBE? A prospective cohort study

Ching

Branchi

Sanders

et al. 2017

Frontline Gastroenterol

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“…Nearly half the patients required more than one procedure to address their problem. The safety and efficacy of DAE have been previously demonstrated by multiple centers [13][14][15][16][17][18][19][20]. DAE is a relatively low-risk endoscopic procedure that provides the ability to obtain tissue for diagnosis, apply therapy, and precisely localize lesions.…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Cancers Diagnosed by Device-Assisted Enteroscopy at a U.S. Referral Center: A Five-Year Experience

et al. 2011

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Small bowel cancer is a rare but important finding on DAE. The per-patient incidence in our series was 3.6%. A recent multicenter Japanese series showing a higher incidence of small bowel tumors (14%) included polyposis syndrome patients and benign lesions, which were excluded from our study. The high frequency of neuroendocrine tumors in our series was also in contrast to the Japanese series, where lymphoma and GIST were more common. This may reflect a difference between our referral populations. Most of our patients underwent surgery as a consequence of these findings, underscoring the importance of identifying these tumors. DAE provides direct endoscopic access to the small bowel and is a valuable tool in the diagnosis of small bowel cancers.

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Double-balloon enteroscopy in the elderly: safety, findings, and diagnostic and therapeutic success

Cited by 43 publications

References 42 publications

The safety and efficacy of single balloon enteroscopy in the elderly

The safety and efficacy of single balloon enteroscopy in the elderly

Paradigm shift: should the elderly undergo propofol sedation for DBE? A prospective cohort study

Small Bowel Cancers Diagnosed by Device-Assisted Enteroscopy at a U.S. Referral Center: A Five-Year Experience

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