Management of small-bowel polyps at double-balloon enteroscopy

Naoki Ohmiya, Masanao Nakamura, Tomomitsu Tahara, Mitsuo Nagasaka, Yoshihito Nakagawa, Tomoyuki Shibata, Yoshiki Hirooka, Hidemi Goto, Ichiro Hirata

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Small bowel tumors (SBTs) are uncommon, insidious in presentation, and frequently represent a diagnostic challenge. The advent of video capsule endoscopy (VCE) and double-balloon endoscopy (DBE) is a significant breakthrough for visual diagnosis of SBTs throughout the small bowel. Contrast-enhanced computed tomography (CECT) and fluoroscopic enteroclysis had significantly lower diagnostic yields of tumors that were 10 mm or smaller in diameter, but VCE and DBE had high diagnostic yields regardless of tumor size. Regarding SBTs larger than 10 mm in diameter, CECT had a significantly lower diagnostic yield of epithelial tumors compared to subepithelial tumors, whereas fluoroscopic enteroclysis and DBE had high diagnostic yields regardless of the tumor type. VCE had a slightly lower diagnostic yield of subepithelial tumors (78%) compared to epithelial tumors. Therefore, a combined examination method by using CECT and VCE is useful for screening of SBTs. In case suspicious of stenosis, patency capsule should be performed to confirm passage before VCE. DBE is useful for further precise examination including biopsy and ultrasonography by using miniature probe, and enteroscopic treatment. After medical, enteroscopic, and surgical treatment, VCE is helpful for follow-up. DBE is safe and useful in resecting the SBTs deep within the small bowel without laparotomy. Indications of enteroscopic resection may be benign tumors regardless of epithelial or subepithelial type, localizing in the mucosal or submucosal layer, which are symptomatic at present or possibly symptomatic or transforming in the future. Malignant tumors localized in the mucosal layer may be indications although detecting at an early stage is challenging. In this review article, we describe management of SBTs/polyps by various modalities.

Original languageEnglish
Article number30
JournalAnnals of Translational Medicine
Volume2
Issue number3
DOIs
Publication statusPublished - 03-2014

Fingerprint

Double-Balloon Enteroscopy
Polyps
Capsule Endoscopy
Neoplasms
Endoscopy
Tomography

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Ohmiya, Naoki ; Nakamura, Masanao ; Tahara, Tomomitsu ; Nagasaka, Mitsuo ; Nakagawa, Yoshihito ; Shibata, Tomoyuki ; Hirooka, Yoshiki ; Goto, Hidemi ; Hirata, Ichiro. / Management of small-bowel polyps at double-balloon enteroscopy. In: Annals of Translational Medicine. 2014 ; Vol. 2, No. 3.
@article{dbf19691e5a7498ab1029d4ca0faadeb,
title = "Management of small-bowel polyps at double-balloon enteroscopy",
abstract = "Small bowel tumors (SBTs) are uncommon, insidious in presentation, and frequently represent a diagnostic challenge. The advent of video capsule endoscopy (VCE) and double-balloon endoscopy (DBE) is a significant breakthrough for visual diagnosis of SBTs throughout the small bowel. Contrast-enhanced computed tomography (CECT) and fluoroscopic enteroclysis had significantly lower diagnostic yields of tumors that were 10 mm or smaller in diameter, but VCE and DBE had high diagnostic yields regardless of tumor size. Regarding SBTs larger than 10 mm in diameter, CECT had a significantly lower diagnostic yield of epithelial tumors compared to subepithelial tumors, whereas fluoroscopic enteroclysis and DBE had high diagnostic yields regardless of the tumor type. VCE had a slightly lower diagnostic yield of subepithelial tumors (78{\%}) compared to epithelial tumors. Therefore, a combined examination method by using CECT and VCE is useful for screening of SBTs. In case suspicious of stenosis, patency capsule should be performed to confirm passage before VCE. DBE is useful for further precise examination including biopsy and ultrasonography by using miniature probe, and enteroscopic treatment. After medical, enteroscopic, and surgical treatment, VCE is helpful for follow-up. DBE is safe and useful in resecting the SBTs deep within the small bowel without laparotomy. Indications of enteroscopic resection may be benign tumors regardless of epithelial or subepithelial type, localizing in the mucosal or submucosal layer, which are symptomatic at present or possibly symptomatic or transforming in the future. Malignant tumors localized in the mucosal layer may be indications although detecting at an early stage is challenging. In this review article, we describe management of SBTs/polyps by various modalities.",
author = "Naoki Ohmiya and Masanao Nakamura and Tomomitsu Tahara and Mitsuo Nagasaka and Yoshihito Nakagawa and Tomoyuki Shibata and Yoshiki Hirooka and Hidemi Goto and Ichiro Hirata",
year = "2014",
month = "3",
doi = "10.3978/j.issn.2305-5839.2014.02.06",
language = "English",
volume = "2",
journal = "Annals of Translational Medicine",
issn = "2305-5839",
publisher = "AME Publishing Company",
number = "3",

}

Management of small-bowel polyps at double-balloon enteroscopy. / Ohmiya, Naoki; Nakamura, Masanao; Tahara, Tomomitsu; Nagasaka, Mitsuo; Nakagawa, Yoshihito; Shibata, Tomoyuki; Hirooka, Yoshiki; Goto, Hidemi; Hirata, Ichiro.

In: Annals of Translational Medicine, Vol. 2, No. 3, 30, 03.2014.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Management of small-bowel polyps at double-balloon enteroscopy

AU - Ohmiya, Naoki

AU - Nakamura, Masanao

AU - Tahara, Tomomitsu

AU - Nagasaka, Mitsuo

AU - Nakagawa, Yoshihito

AU - Shibata, Tomoyuki

AU - Hirooka, Yoshiki

AU - Goto, Hidemi

AU - Hirata, Ichiro

PY - 2014/3

Y1 - 2014/3

N2 - Small bowel tumors (SBTs) are uncommon, insidious in presentation, and frequently represent a diagnostic challenge. The advent of video capsule endoscopy (VCE) and double-balloon endoscopy (DBE) is a significant breakthrough for visual diagnosis of SBTs throughout the small bowel. Contrast-enhanced computed tomography (CECT) and fluoroscopic enteroclysis had significantly lower diagnostic yields of tumors that were 10 mm or smaller in diameter, but VCE and DBE had high diagnostic yields regardless of tumor size. Regarding SBTs larger than 10 mm in diameter, CECT had a significantly lower diagnostic yield of epithelial tumors compared to subepithelial tumors, whereas fluoroscopic enteroclysis and DBE had high diagnostic yields regardless of the tumor type. VCE had a slightly lower diagnostic yield of subepithelial tumors (78%) compared to epithelial tumors. Therefore, a combined examination method by using CECT and VCE is useful for screening of SBTs. In case suspicious of stenosis, patency capsule should be performed to confirm passage before VCE. DBE is useful for further precise examination including biopsy and ultrasonography by using miniature probe, and enteroscopic treatment. After medical, enteroscopic, and surgical treatment, VCE is helpful for follow-up. DBE is safe and useful in resecting the SBTs deep within the small bowel without laparotomy. Indications of enteroscopic resection may be benign tumors regardless of epithelial or subepithelial type, localizing in the mucosal or submucosal layer, which are symptomatic at present or possibly symptomatic or transforming in the future. Malignant tumors localized in the mucosal layer may be indications although detecting at an early stage is challenging. In this review article, we describe management of SBTs/polyps by various modalities.

AB - Small bowel tumors (SBTs) are uncommon, insidious in presentation, and frequently represent a diagnostic challenge. The advent of video capsule endoscopy (VCE) and double-balloon endoscopy (DBE) is a significant breakthrough for visual diagnosis of SBTs throughout the small bowel. Contrast-enhanced computed tomography (CECT) and fluoroscopic enteroclysis had significantly lower diagnostic yields of tumors that were 10 mm or smaller in diameter, but VCE and DBE had high diagnostic yields regardless of tumor size. Regarding SBTs larger than 10 mm in diameter, CECT had a significantly lower diagnostic yield of epithelial tumors compared to subepithelial tumors, whereas fluoroscopic enteroclysis and DBE had high diagnostic yields regardless of the tumor type. VCE had a slightly lower diagnostic yield of subepithelial tumors (78%) compared to epithelial tumors. Therefore, a combined examination method by using CECT and VCE is useful for screening of SBTs. In case suspicious of stenosis, patency capsule should be performed to confirm passage before VCE. DBE is useful for further precise examination including biopsy and ultrasonography by using miniature probe, and enteroscopic treatment. After medical, enteroscopic, and surgical treatment, VCE is helpful for follow-up. DBE is safe and useful in resecting the SBTs deep within the small bowel without laparotomy. Indications of enteroscopic resection may be benign tumors regardless of epithelial or subepithelial type, localizing in the mucosal or submucosal layer, which are symptomatic at present or possibly symptomatic or transforming in the future. Malignant tumors localized in the mucosal layer may be indications although detecting at an early stage is challenging. In this review article, we describe management of SBTs/polyps by various modalities.

UR - http://www.scopus.com/inward/record.url?scp=85015497733&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85015497733&partnerID=8YFLogxK

U2 - 10.3978/j.issn.2305-5839.2014.02.06

DO - 10.3978/j.issn.2305-5839.2014.02.06

M3 - Review article

AN - SCOPUS:85015497733

VL - 2

JO - Annals of Translational Medicine

JF - Annals of Translational Medicine

SN - 2305-5839

IS - 3

M1 - 30

ER -