Endoscopic and histological characteristics of small bowel tumors diagnosed by double-balloon enteroscopy

Abstract

Background/Aims: Double-balloon enteroscopy (DBE) allows for the diagnoses and treatment of small bowel tumors (SBTs). This study aimed to evaluate the utility of DBE for the diagnosis and treatment of SBTs.Methods: Patients diagnosed with SBTs who underwent DBE were included in this study. According to their endoscopic appearances, they were categorized as polyps or masses, and according to their histological characteristics, they were categorized as benign or malignant SBTs.Results: A total of 704 patients were retrospectively analyzed, and 90 (12.8%) were diagnosed with SBTs. According to their endoscopic appearance, 48 (53.3%) had polyps and 42 (46.7%) had masses. Additionally, 53 (58.9%) and 37 (41.1%) patients had malignant and benign SBTs, respectively, depending on their histological characteristics. Patients diagnosed with polyps were younger than those diagnosed with masses (p<0.001). Patients diagnosed with benign SBTs were younger than those diagnosed with malignant SBT (p<0.001). Overall, histological diagnosis was determined using DBE in 73 (81.1%) patients.Conclusions: DBE is a useful method for diagnosing SBTs. Additionally, the histological type of the lesion can be determined using DBE.

Application of double-balloon enteroscopy for small bowel tumors

“…In other studies, the most common malignancies were adenocarcinomas, lymphomas, neuroendocrine tumors, and GISTs, 4 - 7 while adenomatous polyps were the most common type of benign tumors. 8 , 9 Lesions were most often found in the proximal part of the small intestine 3 , 4 , 8 ; therefore, when an asymptomatic SBT is suspected, enteroscopy from the oral route is preferred. The greatest advantage of DBE is localization and tissue acquisition, and in approximately 70% to 80% of cases making a histological diagnosis is possible.…”

“…However, among patients with a mass on endoscopy ( n =42), the histological diagnosis was confirmed using DBE in 25 patients (59.5%). 3 Polyps found in DBE are likely to be histologically diagnosed, and unnecessary surgery can be avoided. DBE was found to be less effective for the histological diagnosis of GIST among other malignant tumors.…”

“…DBE was found to be less effective for the histological diagnosis of GIST among other malignant tumors. 3 , 10 Many cases of GIST are diagnosed postoperatively and can be suspected by preoperative DBE.…”

“…However, double-balloon enteroscopy (DBE) is a good tool that can be used for the visualization and sampling of SBTs. 2 Dolu et al 3 reported the endoscopic and histological characteristics of DBE-diagnosed SBTs. Although the endoscopic classification of SBTs into small intestinal polyps and masses has not been demonstrated, the authors defined polyps as protrusions without ulcers and masses as ulcerative or infiltrative protruding lesions, sessile lesions larger than 3 cm, and submu-cosal lesions.…”