Carbon dioxide insufflation improves the intubation depth and total enteroscopy rate in single-balloon enteroscopy: a randomised, controlled, double-blind trial

Li, Xuan; Zhao, Yun-jia; Dai, Jun; Li, Xiaobo; Xue, Han-bin; Zhang, Yao; Xiong, Guang-su; Ohtsuka, Kazuo; Gao, Yun‐Jie; Liu, Qiang; Song, Yan; Fang, Jing‐Yuan; Ge, Zhi‐Zheng

doi:10.1136/gutjnl-2013-306069

Cited by 40 publications

(61 citation statements)

References 16 publications

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“…Thus, as recommended by a previous study [16], we employed carbon dioxide (CO 2 ) insufflation to reduce post-procedure pain and bowel distention. Intriguingly, previous studies have shown that CO 2 insufflation can even improve the intubation depth and total endoscopy rate of SBE [16,17]. Hence, it will also be interesting to examine the effect of CO 2 insufflation on the efficacy and safety of DBE and SBE in the future.…”

Section: Discussionmentioning

confidence: 97%

Efficacy and Safety of Single-Balloon Versus Double-Balloon Enteroscopy: A Single-Center Retrospective Analysis

Weng

et al. 2017

Med Sci Monit

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BackgroundSingle-balloon endoscopy (SBE) has been introduced as a simplified endoscopy technique after the promotion of double-balloon endoscopy (DBE). The difference in clinical performance between DBE and SBE is still not very clear. In this study, we aimed to compare the efficacy and safety between these 2 endoscopic procedures.Material/MethodsA total of 173 patients with suspected small bowel disease were enrolled into this study from January 2007 to December 2011. All cases were divided into DBE or SBE groups according to the endoscopic procedures they underwent. We then compared the diagnostic yield, the influence of DBE and SBE on the diagnostic/therapeutic course, the examination time, and post-procedure discomfort between DBE and SBE groups.ResultsWe observed no notable adverse events during or after the examinations. Additionally, SBE displays a significantly higher diagnostic rate (62.0%) than DBE (35.6%) via the anal approach (P=0.0137), while there was no difference in positive diagnostic rate between DBE and SBE via the oral route. Remarkably, it takes significantly less time to perform SBE examinations (38.86±5.64 minutes) than DBE procedures (41.80±6.50 minutes) via the oral route (P=0.048), although the average examination time for DBE is close to that for SBE via the anal route (P=0.952). However, DBE and SBE are similar in terms of their impact on the diagnostic/therapeutic course and complication rate.ConclusionsBoth SBE and DBE are very safe procedures to perform and SBE is a preferred choice for the evaluation of small bowel diseases in terms of diagnostic rate via the anal route compared with DBE.

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Section: Discussionmentioning

confidence: 97%

Efficacy and Safety of Single-Balloon Versus Double-Balloon Enteroscopy: A Single-Center Retrospective Analysis

Weng

et al. 2017

Med Sci Monit

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“…6 Li et al reported there was no significant difference between CO 2 group and air group. 8 The different anesthesia approaches might have contributed to the discrepancy. Pooling the results only reached statistical significance at 1 h after the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Hirai et al 6 performed arterial blood gas analysis, and Li et al 8 recorded end-tidal CO 2 after balloon-assisted Figure 2. Forest plot displaying the weighted mean difference (WMD) and 95% confidence intervals (95% CIs) of each study for the intubation depth of oral enteroscopy.…”

Section: Co 2 Retentionmentioning

confidence: 99%

“…5 However, other studies produced inconsistent results. [6][7][8] The number of patients enrolled in some trials has been too few to achieve statistically conclusive results. We proposed that systematically pooling data from all published reports might provide a better understanding of the efficacy of CO 2 insufflation for balloon-assisted enteroscopy.…”

Section: Introductionmentioning

confidence: 99%

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Effects of carbon dioxide insufflation in balloon‐assisted enteroscopy: A systematic review and meta‐analysis

et al. 2016

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Background and aim: The efficacy of CO 2 insufflation during balloon-assisted enteroscopy remains controversial. This study aimed to perform a systematic review with meta-analysis of randomized controlled trials (RCTs) in which CO 2 insufflation was compared with air insufflation in balloon-assisted enteroscopy. Methods: PubMed, the Cochrane library, and the Igaku-Chuo-Zasshi database were searched to identify RCTs eligible for inclusion in the systematic review. Data from the eligible studies were combined to calculate the pooled odds ratios (ORs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs). Results: Four RCTs (461 patients) were identified. Compared with air insufflation, CO 2 insufflation significantly increased intubation depth of oral enteroscopy (WMD: 55.2, 95% CI: 10.77-99.65, p ¼ 0.015). However, there was significant heterogeneity. The intubation depth of anal enteroscopy showed no significant difference between the CO 2 group and the air group. CO 2 insufflation significantly reduced abdominal pain compared with air insufflation (WMD: À2.463, 95% CI: À4.452 to À0.474, p ¼ 0.015), without significant heterogeneity. The PaCO 2 or end-tidal CO 2 level showed no significant difference between the CO 2 group and air group. Conclusions: Compared with air insufflation, CO 2 insufflation during balloon-assisted enteroscopy caused less postprocedural pain without CO 2 retention.

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“…Auch für die Single-Ballon-Enteroskopie konnten neben einer Schmerzreduktion verbesserte Intubationstiefen gezeigt werden -bei Li et al im Mittel ca. 90 cm von oral und anal[28,29]. In der Studie unserer Arbeitsgruppe zeigte sich die verbesserte Eindringtiefe v. a. bei voroperierten Patienten -im Mittel ca.…”

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CO2 – ein Muss in der Endoskopie?

Lenz

Domagk

2015

Endo-Praxis

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Carbon dioxide insufflation improves the intubation depth and total enteroscopy rate in single-balloon enteroscopy: a randomised, controlled, double-blind trial

Abstract: ClinicalTrial.gov identifier: NCT01758900.

Cited by 40 publications

References 16 publications

Efficacy and Safety of Single-Balloon Versus Double-Balloon Enteroscopy: A Single-Center Retrospective Analysis

Efficacy and Safety of Single-Balloon Versus Double-Balloon Enteroscopy: A Single-Center Retrospective Analysis

Effects of carbon dioxide insufflation in balloon‐assisted enteroscopy: A systematic review and meta‐analysis

CO2 – ein Muss in der Endoskopie?

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