Literature DB >> 26078833

Role of double-balloon enteroscopy in malignant small bowel tumors.

Enrique Pérez-Cuadrado Robles1, Pilar Esteban Delgado1, Paloma Bebia Conesa1, Blanca Martínez Andrés1, Milivoj Franulic Guggiana1, Eduardo Alcaraz Mateos1, Mariana Fernández Caballero1, José Luis Rodrigo Agudo1, Silvia Chacón Martínez1, Rafael Latorre1, Federico Soria1, Juan Manuel Herrerías Gutiérrez1, Enrique Pérez-Cuadrado Martínez1.   

Abstract

AIM: To assess the double-balloon enteroscopy (DBE) role in malignant small bowel tumors (MSBT).
METHODS: This is a retrospective descriptive study performed in a single center. All consecutive patients who underwent a DBE with final diagnosis of a malignant neoplasm from 2004 to 2014 in our referral center were included. Patient demographic and clinical pathological characteristics were recorded and reviewed. MSBT diagnosis was achieved either by DBE directed biopsy with multiple tissue sampling, endoscopic findings or histological analysis of surgical specimen. We have analyzed double-balloon enteroscopy impact in outcome and clinical course of these patients.
RESULTS: Of 627 patients, 28 (4.5%) (mean age = 60 ± 17.3 years) underwent 30 procedures (25 anterograde, 5 retrograde) and were diagnosed of a malignant tumor. Patients presented with obscure gastrointestinal bleeding (n = 19, 67.9%), occlusion syndrome (n = 7, 25%) and diarrhea (n = 1, 3.6%). They were diagnosed by DBE biopsy (n = 18, 64.3%), histological analysis of surgical specimen (n = 7, 25%) and unequivocal endoscopic findings (n = 2, 7.1%). Gastrointestinal stromal tumor (n = 8, 28.6%), adenocarcinoma (n = 7, 25%), lymphoma (n = 4, 14.3%), neuroendocrine tumor (n = 4, 14.3%), metastatic (n = 3, 10.7%) and Kaposi sarcoma (n = 1, 3.6%) were identified. DBE modified outcome in 7 cases (25%), delaying or avoiding emergency surgery (n = 3), modifying surgery approach (n = 2) and indicating emergency SB partial resection instead of elective approach (n = 2).
CONCLUSION: DBE may be critical in the management of MSBT providing additional information that may be decisive in the clinical course of these patients.

Entities:  

Keywords:  Double balloon enteroscopy; Gastrointestinal stromal tumor; Malignant small bowel tumors; Obscure gastrointestinal bleeding; Occlusion syndrome

Year:  2015        PMID: 26078833      PMCID: PMC4461939          DOI: 10.4253/wjge.v7.i6.652

Source DB:  PubMed          Journal:  World J Gastrointest Endosc


  35 in total

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2.  Differentiation of Isolated Small Bowel Crohn's Disease from Other Small Bowel Ulcerative Diseases: Clinical Features and Double-Balloon Enteroscopy Characteristics.

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3.  Effectiveness of a dedicated small bowel neoplasia screening program by capsule endoscopy in Lynch syndrome: 5 years results from a tertiary care center.

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Review 6.  The Role of Emergency Endoscopy in Small Bowel Bleeding: A Review.

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