TY - JOUR
T1 - Device-assisted enteroscopy performance measures in the United Kingdom
T2 - DEEP-UK quality improvement project
AU - Shiha, Mohamed G.
AU - Sidhu, Reena
AU - Lucaciu, Laura A.
AU - Palmer-Jones, Christopher
AU - Ayeboa-Sallah, Benjamin
AU - Lazaridis, Nikolaos
AU - Eckersley, Robert
AU - Hiner, George E.
AU - Maxfield, Dominic
AU - Shaheen, Walaa
AU - Abduljabbar, Duaa
AU - Hussain, Muhammad A.
AU - O'Hare, Rosie
AU - Phull, Perminder S.
AU - Eccles, John
AU - Caddy, Grant R.
AU - Butt, Mohammed A.
AU - Kurup, Arun
AU - Chattree, Amit
AU - Hoare, Jonathan
AU - Jennings, Jason
AU - Longcroft-Wheaton, Gaius
AU - Collins, Paul
AU - Humphries, Adam
AU - Murino, Alberto
AU - Despott, Edward J.
AU - Sanders, David S.
PY - 2024/3
Y1 - 2024/3
N2 - Background Device-assisted enteroscopy (DAE) has become a well-established diagnostic and therapeutic tool for the management of small-bowel pathology. We aimed to evaluate the performance measures for DAE across the UK against the quality benchmarks proposed by the European Society of Gastrointestinal Endoscopy (ESGE). Methods We retrospectively collected data on patient demographics and DAE performance measures from electronic endoscopy records of consecutive patients who underwent DAE for diagnostic and therapeutic purposes across 12 enteroscopy centers in the UK between January 2017 and December 2022. Results A total of 2005 DAE procedures were performed in 1663 patients (median age 60 years; 53% men). Almost all procedures (98.1%) were performed for appropriate indications. Double-balloon enteroscopy was used for most procedures (82.0%), followed by single-balloon enteroscopy (17.2%) and spiral enteroscopy (0.7%). The estimated depth of insertion was documented in 73.4% of procedures. The overall diagnostic yield was 70.0%. Therapeutic interventions were performed in 42.6% of procedures, with a success rate of 96.6%. Overall, 78.0% of detected lesions were marked with a tattoo. Patient comfort was significantly better with the use of deep sedation compared with conscious sedation (99.7% vs. 68.5%; P<0.001). Major adverse events occurred in only 0.6% of procedures. Conclusions Performance measures for DAE in the UK meet the ESGE quality benchmarks, with high diagnostic and therapeutic yields, and a low incidence of major adverse events. However, there is room for improvement in optimizing sedation practices, standardizing the depth of insertion documentation, and adopting marking techniques to aid in the follow-up of detected lesions.
AB - Background Device-assisted enteroscopy (DAE) has become a well-established diagnostic and therapeutic tool for the management of small-bowel pathology. We aimed to evaluate the performance measures for DAE across the UK against the quality benchmarks proposed by the European Society of Gastrointestinal Endoscopy (ESGE). Methods We retrospectively collected data on patient demographics and DAE performance measures from electronic endoscopy records of consecutive patients who underwent DAE for diagnostic and therapeutic purposes across 12 enteroscopy centers in the UK between January 2017 and December 2022. Results A total of 2005 DAE procedures were performed in 1663 patients (median age 60 years; 53% men). Almost all procedures (98.1%) were performed for appropriate indications. Double-balloon enteroscopy was used for most procedures (82.0%), followed by single-balloon enteroscopy (17.2%) and spiral enteroscopy (0.7%). The estimated depth of insertion was documented in 73.4% of procedures. The overall diagnostic yield was 70.0%. Therapeutic interventions were performed in 42.6% of procedures, with a success rate of 96.6%. Overall, 78.0% of detected lesions were marked with a tattoo. Patient comfort was significantly better with the use of deep sedation compared with conscious sedation (99.7% vs. 68.5%; P<0.001). Major adverse events occurred in only 0.6% of procedures. Conclusions Performance measures for DAE in the UK meet the ESGE quality benchmarks, with high diagnostic and therapeutic yields, and a low incidence of major adverse events. However, there is room for improvement in optimizing sedation practices, standardizing the depth of insertion documentation, and adopting marking techniques to aid in the follow-up of detected lesions.
UR - http://www.scopus.com/inward/record.url?scp=85177553807&partnerID=8YFLogxK
U2 - 10.1055/a-2199-7155
DO - 10.1055/a-2199-7155
M3 - Article
C2 - 37949103
AN - SCOPUS:85177553807
SN - 0013-726X
VL - 56
SP - 174
EP - 181
JO - Endoscopy
JF - Endoscopy
IS - 3
ER -