Clinical Experience with a New Model Single-Balloon Enteroscope (XSIF-Q260Y) for the Diagnosis and Treatment of Small-Intestinal Diseases

Abstract

Background/Aims: Double-balloon enteroscopy (DBE) has been used to diagnose small intestinal diseases, and its clinical usefulness has been established. However, because balloons have to be attached to both the endoscope and the overtube, DBE requires a long preparation time and insertion of the scope is often difficult. We had the opportunity to use a single-balloon enteroscope (SBE) developed by Olympus Optical Company (XSIF-Q260Y). We compared the features of SBE with those of DBE to examine the clinical usefulness of this new enteroscope. Methods: The study group comprised 14 patients with small intestinal diseases (11 men and 3 women) who underwent SBE (17 sessions). Their mean age was 60.1 years. SBE was mainly performed to further evaluate small intestinal bleeding (6 sessions), to further evaluate or to dilate strictures in Crohn's disease (5 sessions), and to confirm suspected tumors in the small intestine (2 sessions). For SBE, a balloon is attached to only the tip of the overtube. The effective length of the endoscope is 2 m. The outside diameter of the tip is 9.2 mm, smaller than that of a DBE (for treatment). The forceps is 2.8 mm, permitting the use of various devices. The inner surface of the overtube is treated with a hydrophilic lubricant, making the scope easy to slide. Silicon, which is biologically safe, is used. Results: 1) The routes of insertion of SBE were the mouth (7 sessions) and the anus (10 sessions). SBE was inserted easily. In 1 patient in whom SBE was inserted through both the mouth and the anus, nearly the entire small intestine could be endoscopically examined. There were no serious complications. 2) Abnormalities were found on 11 sessions (65%) and comprised Crohn's disease (5 sessions), focal vascular dilation (3 sessions), jejunal diverticula (1 session), ischemic small intestinal stricture (1 session), and hemorrhagic ulcer of the ileum (1 session). 3) As for endoscopic treatment, endoscopic balloon dilation was performed 3 times for strictures of the ileum associated with Crohn's disease, and argon plasma coagulation was performed 1 time to induce hemostasis of a hemorrhagic ileal ulcer. All of the treatments were effective. 4) SBE does not require a balloon to be attached to the scope and has only 1 insufflation tube. Therefore, examination preparations and scope insertion, cleaning, and disinfection are easier than with DBE. Conclusions: Studies comparing SBE with DBE are needed to further assess the ease of insertion of SBE. However, SBE has many advantages, such as convenience and compatibility with conventional systems. We believe that SBE will be more widely used clinically in the future.