TY - JOUR
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
N1 - Funding Information:
DISCLOSURE: This work was supported in part by the Grant-in-Aid for Cancer Research (18-15) from the Ministry of Health, Labour, and Welfare, Japan . H. Goto contributed financial support. No other financial relationships relevant to this publication were disclosed.
PY - 2012/8
Y1 - 2012/8
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.
AB - 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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U2 - 10.1016/j.gie.2012.04.443
DO - 10.1016/j.gie.2012.04.443
M3 - Article
C2 - 22817787
AN - SCOPUS:84864151497
SN - 0016-5107
VL - 76
SP - 344
EP - 354
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 2
ER -