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

E. Rondonotti, M. Pennazio, E. Toth, P. Menchen, M.E. Riccioni, G.D. De Palma, F. Scotto, Danny De Looze UGent, T. Pachofsky and I. Tacheci, et al. (2008) 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 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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
diagnostic yield, small-intestine, patency capsule, term-follow-up, Gastrointestinal stromal tumors, double-balloon enteroscopy, retention, melanoma, cancer
journal title
Endoscopy
volume
40
issue
6
pages
488 - 495
publisher
Georg Thieme Verlag KG
place of publication
Stuttgart, Germany
Web of Science type
Article
Web of Science id
000257075300006
JCR category
SURGERY
JCR impact factor
6.091 (2008)
JCR rank
4/148 (2008)
JCR quartile
1 (2008)
ISSN
0013-726X
DOI
10.1055/s-2007-995783
language
English
UGent publication?
yes
classification
A1
id
519364
handle
http://hdl.handle.net/1854/LU-519364
date created
2009-03-16 15:34:16
date last changed
2009-03-18 11:29:15
@article{519364,
  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, E. and Menchen, P. and Riccioni, M.E. and De Palma, G.D. and Scotto, F. and De Looze, Danny 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         = {0013-726X},
  journal      = {Endoscopy},
  keyword      = {diagnostic yield,small-intestine,patency capsule,term-follow-up,Gastrointestinal stromal tumors,double-balloon enteroscopy,retention,melanoma,cancer},
  language     = {eng},
  number       = {6},
  pages        = {488--495},
  publisher    = {Georg Thieme Verlag KG},
  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},
}

Chicago
Rondonotti, E., M. Pennazio, E. Toth, P. Menchen, M.E. Riccioni, G.D. De Palma, F. Scotto, et al. 2008. “Small-bowel Neoplasms in Patients Undergoing Video Capsule Endoscopy: a Multicenter European Study.” Endoscopy 40 (6): 488–495.
APA
Rondonotti, E., Pennazio, M., Toth, E., Menchen, P., Riccioni, M. E., De Palma, G. D., Scotto, F., et al. (2008). Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study. Endoscopy, 40(6), 488–495.
Vancouver
1.
Rondonotti E, Pennazio M, Toth E, Menchen P, Riccioni ME, De Palma GD, et al. Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study. Endoscopy. Stuttgart, Germany: Georg Thieme Verlag KG; 2008;40(6):488–95.
MLA
Rondonotti, E., M. Pennazio, E. Toth, et al. “Small-bowel Neoplasms in Patients Undergoing Video Capsule Endoscopy: a Multicenter European Study.” Endoscopy 40.6 (2008): 488–495. Print.