Enteroscopic and radiologic diagnoses, treatment, and prognoses of small-bowel tumors

Wataru Honda, Naoki Ohmiya, Yoshiki Hirooka, Masanao Nakamura, Ryoji Miyahara, Eizaburo Ohno, Hiroki Kawashima, Akihiro Itoh, Osamu Watanabe, Takafumi Ando, Hidemi Goto

Research output: Contribution to journalArticle

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Abstract

Background: Small-bowel tumors (SBTs) represent a diagnostic challenge. Objective: To evaluate the usefulness of contrast-enhanced CT (CECT), fluoroscopic enteroclysis (FE), videocapsule endoscopy (VCE), and double-balloon endoscopy (DBE) and the outcome after treatment. Design: Single-center, retrospective study. Setting: Tertiary-care referral hospital. Patients: Between June 2003 and May 2011, 159 consecutive patients with SBTs (93 malignant and 66 benign) were enrolled. Main Outcome Measurements: Comparison of diagnostic yields among CECT, FE, VCE, and DBE and the prognosis. Results: CECT and FE had significantly lower diagnostic yields of SBTs ≤10 mm, but VCE and DBE had high yields of SBTs regardless of size. CECT had a significantly lower diagnostic yield of epithelial tumors compared with subepithelial tumors. When stratified by the site, the diagnostic yield of VCE for SBTs located only in the distal duodenum/the proximal jejunum (73%) was significantly lower than that for SBTs located in other areas (90%). Comparisons among the 4 methods revealed that VCE and DBE had significantly higher diagnostic yields than CECT, and DBE had significantly higher diagnostic yields than VCE, but a combination of CECT and VCE had a diagnostic yield similar to that of DBE. The histologic diagnostic yield of SBTs by DBE was 92%, and 25% of SBTs were enteroscopically treated. Metastatic tumors had the poorest overall survival, followed by adenocarcinomas and malignant lymphomas. Limitations: Retrospective comparative study. Conclusion: For the detection of SBTs, a combination screening method by using VCE and CECT is recommended. DBE is useful for histologic diagnosis and endoscopic treatment.

Original languageEnglish
Pages (from-to)344-354
Number of pages11
JournalGastrointestinal Endoscopy
Volume76
Issue number2
DOIs
Publication statusPublished - 01-08-2012
Externally publishedYes

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Endoscopy
Neoplasms
Therapeutics
Retrospective Studies
Tertiary Healthcare
Jejunum
Duodenum
Tertiary Care Centers
Lymphoma
Adenocarcinoma

All Science Journal Classification (ASJC) codes

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Honda, Wataru ; Ohmiya, Naoki ; Hirooka, Yoshiki ; Nakamura, Masanao ; Miyahara, Ryoji ; Ohno, Eizaburo ; Kawashima, Hiroki ; Itoh, Akihiro ; Watanabe, Osamu ; Ando, Takafumi ; Goto, Hidemi. / Enteroscopic and radiologic diagnoses, treatment, and prognoses of small-bowel tumors. In: Gastrointestinal Endoscopy. 2012 ; Vol. 76, No. 2. pp. 344-354.
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abstract = "Background: Small-bowel tumors (SBTs) represent a diagnostic challenge. Objective: To evaluate the usefulness of contrast-enhanced CT (CECT), fluoroscopic enteroclysis (FE), videocapsule endoscopy (VCE), and double-balloon endoscopy (DBE) and the outcome after treatment. Design: Single-center, retrospective study. Setting: Tertiary-care referral hospital. Patients: Between June 2003 and May 2011, 159 consecutive patients with SBTs (93 malignant and 66 benign) were enrolled. Main Outcome Measurements: Comparison of diagnostic yields among CECT, FE, VCE, and DBE and the prognosis. Results: CECT and FE had significantly lower diagnostic yields of SBTs ≤10 mm, but VCE and DBE had high yields of SBTs regardless of size. CECT had a significantly lower diagnostic yield of epithelial tumors compared with subepithelial tumors. When stratified by the site, the diagnostic yield of VCE for SBTs located only in the distal duodenum/the proximal jejunum (73{\%}) was significantly lower than that for SBTs located in other areas (90{\%}). Comparisons among the 4 methods revealed that VCE and DBE had significantly higher diagnostic yields than CECT, and DBE had significantly higher diagnostic yields than VCE, but a combination of CECT and VCE had a diagnostic yield similar to that of DBE. The histologic diagnostic yield of SBTs by DBE was 92{\%}, and 25{\%} of SBTs were enteroscopically treated. Metastatic tumors had the poorest overall survival, followed by adenocarcinomas and malignant lymphomas. Limitations: Retrospective comparative study. Conclusion: For the detection of SBTs, a combination screening method by using VCE and CECT is recommended. DBE is useful for histologic diagnosis and endoscopic treatment.",
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Honda, W, Ohmiya, N, Hirooka, Y, Nakamura, M, Miyahara, R, Ohno, E, Kawashima, H, Itoh, A, Watanabe, O, Ando, T & Goto, H 2012, 'Enteroscopic and radiologic diagnoses, treatment, and prognoses of small-bowel tumors', Gastrointestinal Endoscopy, vol. 76, no. 2, pp. 344-354. https://doi.org/10.1016/j.gie.2012.04.443

Enteroscopic and radiologic diagnoses, treatment, and prognoses of small-bowel tumors. / Honda, Wataru; Ohmiya, Naoki; Hirooka, Yoshiki; Nakamura, Masanao; Miyahara, Ryoji; Ohno, Eizaburo; Kawashima, Hiroki; Itoh, Akihiro; Watanabe, Osamu; Ando, Takafumi; Goto, Hidemi.

In: Gastrointestinal Endoscopy, Vol. 76, No. 2, 01.08.2012, p. 344-354.

Research output: Contribution to journalArticle

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T1 - Enteroscopic and radiologic diagnoses, treatment, and prognoses of small-bowel tumors

AU - Honda, Wataru

AU - Ohmiya, Naoki

AU - Hirooka, Yoshiki

AU - Nakamura, Masanao

AU - Miyahara, Ryoji

AU - Ohno, Eizaburo

AU - Kawashima, Hiroki

AU - Itoh, Akihiro

AU - Watanabe, Osamu

AU - Ando, Takafumi

AU - Goto, Hidemi

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N2 - Background: Small-bowel tumors (SBTs) represent a diagnostic challenge. Objective: To evaluate the usefulness of contrast-enhanced CT (CECT), fluoroscopic enteroclysis (FE), videocapsule endoscopy (VCE), and double-balloon endoscopy (DBE) and the outcome after treatment. Design: Single-center, retrospective study. Setting: Tertiary-care referral hospital. Patients: Between June 2003 and May 2011, 159 consecutive patients with SBTs (93 malignant and 66 benign) were enrolled. Main Outcome Measurements: Comparison of diagnostic yields among CECT, FE, VCE, and DBE and the prognosis. Results: CECT and FE had significantly lower diagnostic yields of SBTs ≤10 mm, but VCE and DBE had high yields of SBTs regardless of size. CECT had a significantly lower diagnostic yield of epithelial tumors compared with subepithelial tumors. When stratified by the site, the diagnostic yield of VCE for SBTs located only in the distal duodenum/the proximal jejunum (73%) was significantly lower than that for SBTs located in other areas (90%). Comparisons among the 4 methods revealed that VCE and DBE had significantly higher diagnostic yields than CECT, and DBE had significantly higher diagnostic yields than VCE, but a combination of CECT and VCE had a diagnostic yield similar to that of DBE. The histologic diagnostic yield of SBTs by DBE was 92%, and 25% of SBTs were enteroscopically treated. Metastatic tumors had the poorest overall survival, followed by adenocarcinomas and malignant lymphomas. Limitations: Retrospective comparative study. Conclusion: For the detection of SBTs, a combination screening method by using VCE and CECT is recommended. DBE is useful for histologic diagnosis and endoscopic treatment.

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