ABSTRACT
Objective To investigate the clinical application of enteroscopies in China, and to further provide evidence for popularization and promotion of enteroscopies. Methods The survey was designed between January 1st , 2017 and July 31th , 2017 with pre-survey in Guangdong Province between May 1st , 2017 and July 31st , 2017. It was conducted in Chinese mainland between August 30th , 2017 and December 30th , 2017. Data were collected through the online survey and reality survey at 385 hospitals. A total of 373 hospitals gave feedbacks and 7 hospitals were unqualified for further analysis after data checking, so 366 hospitals were included for final analysis, with a responding rate of 95. 1％. Information on practice status of hospitals with enteroscopies and enteroscopists were collected. The chi-squared test was used for comparison of data between eastern and central and western regions. Results The hospitals owning enteroscopies accounted for 47. 0％ ( 172/366 ) , 154/172 ( 89. 5％) were tertiary referral hospitals, 112/172 ( 65. 1％) established enteroscopy units, and 84/172 ( 48. 8％) owned X-ray exclusive for enteroscopy. The proportion of enteroscopists with senior title was 40. 3％ (50/124), female enteroscopists accounted for 42. 7％ ( 53/124 ) . Most enteroscopists aged 31-40 ( 50. 8％) and 41-50 years ( 27. 4％) . 43. 0％ ( 74/172) hospitals employed only 1-2 enteroscopists. The diagnostic cases per year were less than 50 cases in 51. 2％ hospitals ( 88/172) . The therapeutic cases per year were less than 10 cases in 51. 7％hospitals ( 89/172 ) . Nineteen of 124 ( 15. 3％) of enteroscopists didn' t receive standard training. The number of hospitals performing enteroscopies in eastern regions was higher than that in central and western regions [111(51. 6％) VS 61(40. 4％), P=0. 034]. The training background of enteroscopists in eastern regions was better than that in central and western regions. Untrained endoscopists accounted for 10. 5％ in eastern regions, while those accounted for 22. 9％ in central and western regions with significant difference ( P=0. 031 ) . Conclusion Low number of patients treated and shortage of enteroscopists are obvious in Chinese mainland, especially in central and western regions. Standard training of enteroscopists is impending.
ABSTRACT
Objective To compare the role of CTE and CE on the diagnosis of small bowel diseases and evaluate their advantages in patients with different indications.Methods Patients underwent both CTE and CE(interval time <2 weeks)at our institution in recent 3 years were enrolled.The positive detection rates,lesion properties and characteristics of CTE and CE were compared.The diagnostic accuracy of combined method was also analyzed.Results A total of 47 patients were enrolled and the indications included suspected or established Crohn′s disease (28 cases),unexplained abdominal pain (14 cases), obscure gastrointestinal bleeding(3 cases),insufficient small bowel obstruction(1 case)and protein losing enteropathy(1 case).Diagnostic yield of CTE and CE for whole small bowel disorders showed no significant difference(CE 83.0% VS CTE 78.7%,P =0.791).For suspected or established CD,CE had a higher diagnostic accuracy than CTE (78.6% VS 35.7%,P =0.002 ),especially in detecting lesions in the jejunum(CE 50.0% VS CTE 7.1%,P =0.002).The diagnostic accuracy reached 100.0% when two meth-ods were combined.For unexplained abdominal pain,no significant difference was found in the diagnostic ac-curacy of CE and CTE(CTE 42.8% VS CE 50.0%,P =1.000).Diagnostic accuracy of combining CTE and CE was 85.7%.Conclusion CTE and CE are both valuable in detecting small bowel lesions.For pa-tients with suspected or established CD,CE is better than CTE.For patients with unexplained abdominal pain,a combination of CTE and CE may be a better strategy than use CTE or CE alone.