Device assisted enteroscopy in the elderly — A systematic review and meta-analysis

Zammit, Stefania Chetcuti; Sanders, David S.; Sidhu, Reena

doi:10.1016/j.dld.2019.04.001

Cited by 7 publications

(7 citation statements)

References 45 publications

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“…Another recent systematic review and meta-analysis reported an overall diagnostic yield of 0.68 (95% confidence interval [CI] 0.59–0.76, P = 0.000001) and therapeutic yield of 0.45 (95% CI 0.39–0.52; P = 0.00001) for device-assisted enteroscopy in elderly patients. [ 14 ] Equivalent or even higher yield rates may be attainable with MSE with good case selection, as suggested by our results.…”

Section: Discussionsupporting

confidence: 71%

Motorised spiral enteroscopy: pilot experience from a tertiary care centre in Singapore

Liang¹

2022

Singapore Medical Journal

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Section: Discussionsupporting

confidence: 71%

Motorised spiral enteroscopy: pilot experience from a tertiary care centre in Singapore

Liang¹

2022

Singapore Medical Journal

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“…Evidence to date is mainly from retrospective studies, which suggest no difference in outcomes even when including elderly groups. [178][179][180] As for other advanced endoscopic procedures, the choice of sedation regimen depends on patient-related, clinical factors, technical issues (eg, expected procedure duration, planned therapy, etc) and also on local organisational protocols.…”

Section: Level Of Agreement: 100%mentioning

confidence: 99%

British Society of Gastroenterology guidelines on sedation in gastrointestinal endoscopy

Sidhu,

Turnbull,

Haboubi

et al. 2023

Gut

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Over 2.5 million gastrointestinal endoscopic procedures are carried out in the United Kingdom (UK) every year. Procedures are carried out with local anaesthetic r with sedation. Sedation is commonly used for gastrointestinal endoscopy, but the type and amount of sedation administered is influenced by the complexity and nature of the procedure and patient factors. The elective and emergency nature of endoscopy procedures and local resources also have a significant impact on the delivery of sedation. In the UK, the vast majority of sedated procedures are carried out using benzodiazepines, with or without opiates, whereas deeper sedation using propofol or general anaesthetic requires the involvement of an anaesthetic team. Patients undergoing gastrointestinal endoscopy need to have good understanding of the options for sedation, including the option for no sedation and alternatives, balancing the intended aims of the procedure and reducing the risk of complications. These guidelines were commissioned by the British Society of Gastroenterology (BSG) Endoscopy Committee with input from major stakeholders, to provide a detailed update, incorporating recent advances in sedation for gastrointestinal endoscopy.This guideline covers aspects from pre-assessment of the elective ‘well’ patient to patients with significant comorbidity requiring emergency procedures. Types of sedation are discussed, procedure and room requirements and the recovery period, providing guidance to enhance safety and minimise complications. These guidelines are intended to inform practising clinicians and all staff involved in the delivery of gastrointestinal endoscopy with an expectation that this guideline will be revised in 5-years’ time.

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“…There are few studies that analyse DBE performance by age groups, mostly carried out in Asian countries [ 5 , 10 , 11 , 23 , 27 ]. A systematic review and meta-analysis by Chetcuti Zammit et al on DAE demonstrated a higher diagnostic and therapeutic yield in the elderly compared to adult patients [ 24 ]. This finding has recently been corroborated by an Italian monocentric retrospective study, in the specific setting of small bowel bleeding [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade, various studies on DBE have reported the indications, diagnostic and therapeutic yield, and complications rate for small bowel diseases worldwide, in particular in the setting of bleeding [ 3 , 5 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Double-balloon enteroscopy can be performed with acceptable safety in the elderly, even with high ASA class [ 22 ], but few retrospective studies had focused on the above-mentioned outcomes of DBE in relation to different ages, mostly from China [ 5 , 10 , 11 , 23 , 24 , 25 , 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Double Balloon-Enteroscopy in Elderly vs. Adult Patients: A Retrospective 16-Year Single-Centre Study

et al. 2023

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Background and Aim: Double-balloon enteroscopy (DBE) is a well-established procedure for direct visualisation of the entire small bowel mucosa, and, in contrast with other imaging techniques, allows to perform biopsies and therapeutic interventions. The aim of this study was to evaluate the indications, diagnostic yield, therapeutic yield, and complications of DBE in a cohort of consecutive patients according to patients’ age. Methods: We conducted a retrospective study of consecutive patients who underwent DBE in our endoscopy unit between January 2006 and December 2021. Results: A total of 387 consecutive patients who underwent 460 DBE procedures were included. Mean age of the patients was 63 years. The overall diagnostic yield was 67.6%; vascular lesions were the predominant endoscopic findings (31.5%), followed by polyps or neoplastic masses (17.6%). Older patients (≥65 years) showed statistically higher rates of clinically relevant findings than adult patients (18–65 years) (p = 0.001). Crohn’s disease and polyps or neoplastic masses were more frequent in the younger group (p = 0.009 and p = 0.066, respectively), while vascular lesions and non-specific inflammation were the most common findings in the older group (p < 0.001 and p < 0.001, respectively). The therapeutic intervention rate was 31.7%. Rates of endoscopic treatment were significantly higher in the older group (p < 0.001). Total complications occurred in five procedures (1.1%). Conclusion: In clinical practice, DBE is an efficient diagnostic and therapeutic tool with a high safety profile, particularly in the elderly population.

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Device assisted enteroscopy in the elderly — A systematic review and meta-analysis

Cited by 7 publications

References 45 publications

Motorised spiral enteroscopy: pilot experience from a tertiary care centre in Singapore

Motorised spiral enteroscopy: pilot experience from a tertiary care centre in Singapore

British Society of Gastroenterology guidelines on sedation in gastrointestinal endoscopy

Outcomes of Double Balloon-Enteroscopy in Elderly vs. Adult Patients: A Retrospective 16-Year Single-Centre Study

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