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Update endoskopische Dünndarmdiagnostik

Gibt es Fortschritte?

Update on small bowel enteroscopy

Innovations?

  • Schwerpunkt
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Der Gastroenterologe Aims and scope

Zusammenfassung

Hintergrund

Die Endoskopie des tiefen Dünndarms ist eine Herausforderung. Erst die technischen Entwicklungen der letzten 2 Jahrzehnte machen eine Routineuntersuchung möglich.

Fragestellung

Gibt es Fortschritte in der endoskopischen Dünndarmdiagnostik?

Material und Methoden

Systematische Aufarbeitung der Thematik anhand der aktuellen Literatur und der Expertise aus einem Schwerpunktzentrum für Dünndarmdiagnostik.

Ergebnisse

Mithilfe der deviceassistierten Enteroskopie (DAE) wurde die technische Möglichkeit für eine endoskopische Diagnostik der tiefen Dünndarmabschnitte geschaffen. Die ballonassistierten Verfahren (BAE) revolutionierten die Enteroskopie durch höhere Eindringtiefen und die Möglichkeit zu Interventionen. Sie sind am weitesten verbreitet. Nachteil sind der hohe Zeit- und Personalaufwand. Erste Daten zur neuen motorisierten Spiralenteroskopie (NMSE) sind vielversprechend und weisen bei geringerem Zeit- und Personalaufwand und erhaltenem Risikoprofil hohe Eindringtiefen und Raten an kompletten Enteroskopien auf. Interventionen werden erleichtert. Kontraindikationen sind zu beachten.

Schlussfolgerung

Die motorisierte Spiralenteroskopie reformiert die Enteroskopie und erweitert als neue Plattform die Verfahren der DAE.

Abstract

Background

Endoscopic examination of the small intestine is still challenging. However, due to technological advances in the past two decades, it is now part of routine clinical use.

Objectives

What are recent developments in endoscopic small bowel diagnostics?

Materials and methods

Systematic review of the available literature and report on the experience from an expert center.

Results

Device-assisted enteroscopy (DAE) forms the technical basis for endoscopic examination of the deep sections of the small intestine. The balloon-assisted procedures (BAE) revolutionized enteroscopy by deeper insertion depth and the option for interventions. Disadvantages are high resource needs with respect to operating time and trained staff involved. Preliminary data about newly developed motorized spiral enteroscopy (NMSE) are promising and show high insertion depths and rates of complete enteroscopy with a comparable risk profile, less expenditure of time and lower personnel expenses. Interventions are less difficult and therefore safer, as long as contraindications are respected.

Conclusion

Motorized spiral enteroscopy leads to significant quality improvement, as it can increase the rate of complete and successful enteroscopies and therefore expands treatment options to include procedures of device-assisted enteroscopy.

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Author information

Authors and Affiliations

  1. Klinik für Gastroenterologie, Hepatologie und interventionelle Endoskopie, Klinikum Traunstein, Klinken Südostbayern AG, Cuno-Niggl-Straße 3, 83278, Traunstein, Deutschland

    Björn Lewerenz

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  1. Björn Lewerenz
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Correspondence to Björn Lewerenz.

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Interessenkonflikt

B. Lewerenz gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Redaktion

Arthur Schmidt, Freiburg

Michael Fried, Zürich

Ralf Jakobs, Ludwigshafen

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Lewerenz, B. Update endoskopische Dünndarmdiagnostik. Gastroenterologe 17, 86–92 (2022). https://doi.org/10.1007/s11377-021-00588-2

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