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Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study

Rondonotti, E; Pennazio, M; Toth, Ervin LU ; Menchen, P; Riccioni, M E; De Palma, G D; Scotto, F; De Looze, D; Pachofsky, T and Tacheci, I, et al. (2008) In Endoscopy 40(6). p.488-495
Abstract
Background and study aim: Small-bowel tumors account for 1%-3% of all gastrointestinal neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previously reported. The aim of the study was to evaluate the frequency, clinical presentation, diagnostic/therapeutic work-up, and endoscopic appearance of small-bowel tumors in a large population of patients undergoing VCE. Patients and methods: Identification by a questionnaire of patients with VCE findings suggesting small-bowel tumors and histological confirmation of the neoplasm seen in 29 centers of 10 European Countries. Results: Of 5129 patients undergoing VCE, 124 (2.4%) had small-bowel tumors (112 primary, 12... (More)
Background and study aim: Small-bowel tumors account for 1%-3% of all gastrointestinal neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previously reported. The aim of the study was to evaluate the frequency, clinical presentation, diagnostic/therapeutic work-up, and endoscopic appearance of small-bowel tumors in a large population of patients undergoing VCE. Patients and methods: Identification by a questionnaire of patients with VCE findings suggesting small-bowel tumors and histological confirmation of the neoplasm seen in 29 centers of 10 European Countries. Results: Of 5129 patients undergoing VCE, 124 (2.4%) had small-bowel tumors (112 primary, 12 metastatic). Among these patients, indications for VCE were: obscure gastrointestinal bleeding (108 patients), abdominal pain (9), search for primary neoplasm (6), diarrhea with malabsorption (1). The main primary small-bowel tumor type was gastrointestinal stromal tumor (GIST) (32%) followed by adenocarcinoma (20%) and carcinoid (15%); 66% of secondary small-bowel tumors were melanomas. Of the tumors, 80.6% were identified solely on the basis of VCE findings. 55 patients underwent WE as the third procedure after negative bidirectional endoscopy. The lesions were single in 89.5 % of cases, and multiple in 10.5%. Retention of the capsule occurred in 9.8% of patients with small-bowel tumors. After VICE, 54/124 patients underwent 57 other examinations before treatment; in these patients enteroscopy, when performed, showed a high diagnostic yield. Treatment was surgery in 95% of cases. Conclusions: Our data suggest that VCE detects small-bowel tumors in a small proportion of patients undergoing this examination, but the early use of this tool can shorten the diagnostic workup and influence the subsequent management of these patients. (Less)
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publishing date
type
Contribution to journal
publication status
published
subject
in
Endoscopy
volume
40
issue
6
pages
488 - 495
publisher
Georg Thieme Verlag
external identifiers
  • wos:000257075300006
  • scopus:46249132017
ISSN
1438-8812
DOI
10.1055/s-2007-995783
language
English
LU publication?
yes
id
c471025d-32fd-4bd6-b983-2721626a4efc (old id 1186984)
date added to LUP
2008-09-04 10:41:01
date last changed
2017-07-30 03:38:08
@article{c471025d-32fd-4bd6-b983-2721626a4efc,
  abstract     = {Background and study aim: Small-bowel tumors account for 1%-3% of all gastrointestinal neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previously reported. The aim of the study was to evaluate the frequency, clinical presentation, diagnostic/therapeutic work-up, and endoscopic appearance of small-bowel tumors in a large population of patients undergoing VCE. Patients and methods: Identification by a questionnaire of patients with VCE findings suggesting small-bowel tumors and histological confirmation of the neoplasm seen in 29 centers of 10 European Countries. Results: Of 5129 patients undergoing VCE, 124 (2.4%) had small-bowel tumors (112 primary, 12 metastatic). Among these patients, indications for VCE were: obscure gastrointestinal bleeding (108 patients), abdominal pain (9), search for primary neoplasm (6), diarrhea with malabsorption (1). The main primary small-bowel tumor type was gastrointestinal stromal tumor (GIST) (32%) followed by adenocarcinoma (20%) and carcinoid (15%); 66% of secondary small-bowel tumors were melanomas. Of the tumors, 80.6% were identified solely on the basis of VCE findings. 55 patients underwent WE as the third procedure after negative bidirectional endoscopy. The lesions were single in 89.5 % of cases, and multiple in 10.5%. Retention of the capsule occurred in 9.8% of patients with small-bowel tumors. After VICE, 54/124 patients underwent 57 other examinations before treatment; in these patients enteroscopy, when performed, showed a high diagnostic yield. Treatment was surgery in 95% of cases. Conclusions: Our data suggest that VCE detects small-bowel tumors in a small proportion of patients undergoing this examination, but the early use of this tool can shorten the diagnostic workup and influence the subsequent management of these patients.},
  author       = {Rondonotti, E and Pennazio, M and Toth, Ervin and Menchen, P and Riccioni, M E and De Palma, G D and Scotto, F and De Looze, D and Pachofsky, T and Tacheci, I and Havelund, T and Couto, G and Trifan, A and Kofokotsios, A and Cannizzaro, R and Perez-Quadrado, E and de Franchis, R},
  issn         = {1438-8812},
  language     = {eng},
  number       = {6},
  pages        = {488--495},
  publisher    = {Georg Thieme Verlag},
  series       = {Endoscopy},
  title        = {Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study},
  url          = {http://dx.doi.org/10.1055/s-2007-995783},
  volume       = {40},
  year         = {2008},
}