Table 3.
Findings, diagnostic and therapeutic yield, and complications in the different studies
| Study | Findings | Diagnostic yield | Therapeutic yield | Complications |
|---|---|---|---|---|
| Hedge et al. [23] | Main finding − angiodysplasia: all − 28.7%; elderly − 39%. younger − 23% (p = 0.01) Polyps/mass lesions were the next most common finding (13.1%), then small-bowel erosions/ulcers (11.7%); no significant differences between groups |
All: 53.2%; elderly − 55.7%; younger − 51.8% (p = 0.8) |
Endoscopic therapy: all − 35.7%; elderly − 46.8%; younger − 29.2% (p = 0.01) Therapeutic success: all − 85.7%; elderly − 86.5; younger − 85% (p > 0.5) |
Immediately after the procedure and on the basis of follow-up telephone calls 24–48 h after the procedure Complication rate: all − 0.9%; elderly − 0%; younger − 1.4% with transient hypoxia or arrhythmia (p = 0.5) No deaths were observed |
| He et al. [20] | Main finding − primary or metastatic tumors (15/51) Others: diverticula − 7/51; single ulcer − 5/51; angiodysplasias − 4/51; erosions − 2/51 |
64.4% DY for SB diseases of 60.8% | TY = 34% (endoscopic therapy in 20 patients) Surgical in 23 and intra-operative enteroscopy in 1 |
Severe complications were not found during and after DBE Levels of systolic and diastolic blood pressure decreased slightly after DBE |
| Byeon et al. [21] | Main finding − angiodysplasia (30.8%) Next common findings − ulcer and/ or erosion of nonspecific etiology (7.0%) |
60.3% | 38.8% | Complication rate general − 3.7% Pancreatitis: 1.4% Hypoxia after DBE procedures: 1.4% Aspiration pneumonia: 0.9% and treated with antibiotics Small amount of peritoneal free air after DBE ERCP: 0.5% No inadvertent perforation as a result of the DBE procedure Levels of systolic and diastolic blood pressure decreased slightly after DBE |
| Sidhu et al. [27] | Main finding − angiodysplasia: all − 25.7%; elderly − 47.5%; younger − 17.6% (NA statistical significance) Normal: all − 52.7%; elderly − 37.5%; younger − 58.3% (NA statistical significance) |
All: <I>NA</I>; elderly − 53%; younger − 35% (p = 0.06) Increasing age (p = 0.008) and positive CE findings (p = 0.010) associated with a higher yield |
All: 45% treated vascular lesions (APC) Management changed: all − 50%; elderly − 50%; younger − 28% (p = 0.01) Increasing age (p = 0.006) and positive CE findings (p = 0.016) predicted a change in management |
Elderly: no complications or procedure-related deaths at 30 days Younger: respiratory arrest occurred in 1 patient in DPOC (type 2 respiratory failure) (NA statistical significance) |
| Choi et al. [24] | Most common diagnosis: all − mucosal lesions: elderly − 33.3%; younger − 60.9% (p = 0.002) > The most common and detailed final diagnosis: elderly − drug-induced enteropathy younger − CD or tuberculosis Second common diagnosis all − tumor lesions; elderly − 30.8%; younger − 14.1% (p = 0.005) |
All: <I>NA</I>; elderly − 92.3%; younger − 86.5% (p = 0.422) |
Endoscopic therapy: all − 15.2%; elderly − 23.5%; younger − 12.9% (p = 0.17) Interventional therapy (endoscopic + surgery): all − 29.7%; elderly − 50%; younger − 24.2% (p = 0.006) Medical therapy: all − 70.3%; elderly − 50%; younger − 75.8% (p = 0.006) Therapeutic success: elderly − 100%; younger − 87.5% (p > 0.05) |
Complication rate: all − 1.8%; elderly − 2.6%; younger − 1.8% (p = 0.548) elderly − transient hypoxia 0.5% younger − intervention-related bleeding 0.9%; pancreatitis 0.5% No perforations or deaths related to DBE were reported in both groups |
| Cangemi et al. [22] | Main finding − nonbleeding angiodysplasia (43.7%) Next common finding − bleeding angiodysplasia (17.2%) |
77.2% Diagnostic yield for OGIB − 76.5% |
59.5% APC − 99.2% of the therapeutic procedures and 59.1% of all procedures |
No immediate postprocedural complications noted within 48 h |
| Chen et al. [34] | Main finding: all − Crohn's disease (33.4%); elderly − tumor (73.4%); younger − Crohn's disease (48%) (NA statistical significance) Next common finding: all − tumor (18.8%); elderly − angiodysplasia (24.5%); younger − tumor (10.4%) (NA statistical significance) |
All: 70.9%. elderly: 78.6%; middle-aged: 71.2%; younger: 73% (NA statistical significance) |
All − 8.23% (60/729) hemostasis − 28.3%; polypectomy − 25% (NA data of each group) |
Complication rate: all − 0.96% (3 patients with perforation, 2 patients with postprocedural hemorrhage, and 1 patient with aspiration pneumonia) (NA data of each group) |
| Davis-Yadley et al. [25] | Main finding − angiodysplasia: all − 34.7%; ≥75 y − 39.6%; 65–74 y − 37%; 55–64 y − 30%; <55 y − 13.6% (between all older groups and the youngest group p < 0.01) Tumors: all − 3%; ≥75 y − 2%; 65–74 y − 0.8%; 55–64 y − 1.1%; <55 y − 5.9% (between all older groups and the youngest group p > 0.05) |
All − 67.5%; ≥75 years − 66.3%; 65–74 − 59.7%; 55–64 − 55.6%; <55 − 50% (only p < 0.05 between the oldest group and the youngest group) | All − 44.2%; ≥75 years − 47.5%; 65–74 − 42%; 55–64 − 44.4%; <55 − 20.3% (between all older groups and the youngest group p < 0.05) | Minor complications (bradycardia, supraventricular tachycardia and mild bleeding): all: 1.4%; ≥75 years − 1%; 65–74 − 0; 55–64 − 1.1%; <55 − 2.5% (between all older groups and the youngest group, p >0.05) Major complications (hemodynamic instability, bowel perforation and balloon trauma): all: 1.4%; ≥75 years − 2%; 65–74 − 2.5%; 55–64 − 1.1%; <55 − 0 (NA statistical significance) Overall complication rate: all: 2.8%; ≥75 years − 2%; 65–74 − 2.5%; 55–64 − 2.2%; <55 − 2.5% (between all older groups and the youngest group, p >0.05) |
| Chang et al. [26] | Main finding − Mucosal lesions: 41.7% Next finding tumor lesions: 36.9% Angiodysplasia: all − 17.8%; elderly − 37.5%; younger − 8% (p < 0.001) Diverticulum: all − 10.7%; elderly − 25%; younger − 3.6% (p < 0.001) Ulcer/erosion: all − 36.9%; elderly − 23.2%; younger − 43.8% (p = 0.01) IBD: all − 4.8%; elderly − 0; younger − 7.1% (p = 0.04) |
All − 59.5%; elderly − 75%; younger − 51.8% (p = 0.004) |
All − 26.2%; elderly − 39.3%; younger − 16.9% (p = 0.001) |
Complication rate: all − 3.6%; elderly − 5.4%; younger − 2.7% (p = 0.37) |
| Pinho et al. [19] | Main finding − angiodysplasias (25.8%). Next common finding: tumor/polyps and Crohn's disease (NA data of each group) |
Anesthetic complications requiring interruption of the procedures were reported in 9 (0.6%) patients, all under deep propofol sedation, 6 of them aged 65 or older (p > 0.05) | ||
| Lin et al. [35] | Main finding: all − angiodysplasia (15.2%) <30 years − Meckel's diverticulum (17.7%) 30–65 years − non-specific ulcer (26.9%) >65 years − angiodysplasia (27%) (NA statistical significance) |
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| Pattni et al. [28] | Main finding: all − angiodysplasia (25.6%) | Older patients were more likely to have an abnormal examination (mean age normal examination 60.3 vs. abnormal examination 67.9 years, p < 0.001) | Elderly − 78.5%; younger − 37.9% (p < 0.001) |
Procedure was better tolerated in older patients (p = 0.001) 0.4% complication rate related to sedation in an elderly patient (80 years) |
| Tao et al. [36] | Main finding: all − mucosal lesions (17.2%) elderly: vascular malformations younger (<45 y): small intestinal diseases except for lymphoma, protuberant lesions, vascular malformations, and undetermined bleeding |
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NA, not available; DY, diagnostic yield; TY, therapeutic yield; CE, capsule endoscopy; DBE, double-balloon enteroscopy; SBE, single balloon enteroscopy; APC, argon plasma coagulation; CPOD, chronic pulmonary obstructive disease.