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

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49 Citations (Scopus)

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

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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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, 76(2), 344-354. https://doi.org/10.1016/j.gie.2012.04.443