Role of double-balloon enteroscopy in malignant smallbowel tumors

• 作者: Blanca Martínez Andrés Eduardo Alcaraz Mateos Enrique Pérez-Cuadrado Martínez. Enrique Pérez-Cuadrado Robles Federico Soria José Luis Rodrigo Agudo Juan Manuel Herrerías Gutiérrez Mariana Fernández Caballero Milivoj Franulic Guggiana Paloma Bebia Conesa Pilar Esteban Delgado Rafael Latorre Silvia Chacón Martínez
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Double BALLOON ENTEROSCOPY Malignantsmall bowel TUMORS Obscure GASTROINTESTINAL bleeding GASTROINTESTINAL STROMAL tumor OCCLUSION syndrome
• 年，卷（期）: 2015,（6）
• 页码范围: 652-658
• 页数: 7页
• 分类号: R

摘要

AIM To assess the double-balloon enteroscopy （DBE）role in malignant small bowel tumors （MSBT）.METHODS： This is a retrospective descriptive studyperformed in a single center. All consecutive patientswho underwent a DBE with final diagnosis of a malignantneoplasm from 2004 to 2014 in our referralcenter were included. Patient demographic and clinicalpathological characteristics were recorded and reviewed.MSBT diagnosis was achieved either by DBE directed biopsy with multiple tissue sampling, endoscopic findingsor histological analysis of surgical specimen. We haveanalyzed double-balloon enteroscopy impact in outcomeand 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%） anddiarrhea （n = 1, 3.6%）. They were diagnosed by DBEbiopsy （n = 18, 64.3%）, histological analysis of surgicalspecimen （n = 7, 25%） and unequivocal endoscopicfindings （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 indicatingemergency SB partial resection instead of electiveapproach （n = 2）.CONCLUSION： DBE may be critical in the managementof MSBT providing additional information that may bedecisive in the clinical course of these patients.