Small Bowel Disease Clinical Trial
— MSESBOfficial title:
Prospective Evaluation of the Utility of Motorized Spiral Enteroscopy in Patients With Suspected Small Bowel Pathology
Diagnosis and treatment of small bowel pathologies remain challenging due to the long length of the small bowel. Obscure gastrointestinal (GI) bleeding with negative upper and lower GI workup, suspected inflammatory bowel disease, and suspected tumors of the small bowel often require small bowel investigation. While video capsule endoscopy (VCE) and computed tomography (CT) enteroclysis (CTE) are often the initial diagnostic modalities for suspected small bowel pathologies and can provide structural information of the small bowel mucosa, biopsy or therapy for the detected pathology could not be performed with VCE or CTE. In patients who require biopsy or therapy of the detected small bowel pathology, deep enteroscopy would be the procedure of choice in modern clinical practice before subjecting patient to surgery. Diagnostic and therapeutic deep enteroscopy can be performed by balloon overtube assisted enteroscopy (eg, double balloon enteroscopy (DBE), single balloon enteroscopy (SBE) or spiral overtube assisted enteroscopy (SE). Despite the difference in equipment design of DBE, SBE, and SE, the concepts for small bowel intubation by pleating the intestine over the endoscope are the same behind these techniques. Depending on the location of the small bowel pathology reported by VCE or CTE, antegrade (oral route), retrograde (anal route), or combined antegrade and retrograde deep enteroscopy for total enteroscopy can be performed.
Status | Recruiting |
Enrollment | 100 |
Est. completion date | June 30, 2025 |
Est. primary completion date | December 31, 2024 |
Accepts healthy volunteers | |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Age = 18 years - Patients with suspected small bowel pathology based on clinical presentation, small bowel imaging or capsule endoscopy indicated for diagnostic and/or therapeutic enteroscopy - Written informed consent available Exclusion Criteria: - Contraindications for endoscopy due to comorbidities - Unable to provide written informed consent - Patients with known severe GI tract inflammation, intestinal obstruction, gastroesophageal varices that preclude a safe enteroscopy procedure - Coagulopathy or thrombocytopenia that cannot be corrected by blood product transfusion - Pregnant patients - Moribund patients from terminal illnesses |
Country | Name | City | State |
---|---|---|---|
Hong Kong | Prince of Wales Hospital, The Chinese University of Hong Kong | Sha Tin | New Territories |
Lead Sponsor | Collaborator |
---|---|
Chinese University of Hong Kong |
Hong Kong,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Diagnostic yield | Diagnostic yield: defined as successful identification of the suspected pathology based on clinical presentation, pre-MSE small bowel imaging or capsule endoscopy | peri-procedure | |
Secondary | Technical success | - defined as successful advancement of enteroscope beyond the ligament of Treitz for antegrade procedures, or successful advancement of enteroscope proximal to the ileocecal valve for retrograde procedures | peri-procedure | |
Secondary | Therapeutic yield | Therapeutic yield: defined as successful endoscopic interventions such as treatment for GI bleeding, polypectomy, etc | peri-procedure | |
Secondary | Insertion time | Insertion time: defined as time to the maximal depth of insertion in small bowel | peri-procedure | |
Secondary | Maximal depth of insertion in small bowel | Maximal depth of insertion in small bowel | peri-procedure | |
Secondary | Rate of total enteroscopy | Rate of total enteroscopy achieved by antegrade approach alone or combined antegrade and retrograde approaches if total enteroscopy is indicated by findings on pre-MSE small bowel imaging or capsule endoscopy | peri-procedure | |
Secondary | Adverse events related to procedure | Adverse events related to procedure | peri-procedure |
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