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Capsule endoscopy in small bowel tumors: A multicenter Korean study
Authors:Dae Young Cheung  In‐Seok Lee  Dong Kyung Chang  Jin Oh Kim  Jae Hee Cheon  Byung Ik Jang  Yong‐Sik Kim  Cheol Hee Park  Kwang Jae Lee  Ki‐Nam Shim  Ji‐Kon Ryu  Jae‐Hyuk Do  Jeong‐Seop Moon  Byong Duk Ye  Kyung‐Jo Kim  Yun Jeong Lim  Myung‐Gyu Choi  Hoon‐Jai Chun
Affiliation:1. Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea,;2. Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea,;3. Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Seoul, Korea,;4. Department of Internal Medicine, Younsei University College of Medicine, Seoul, Korea,;5. Department of Internal Medicine, Yeungnam University College of Medicine, Seoul, Korea,;6. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea,;7. Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea,;8. Department of Internal Medicine, Ajou University College of Medicine, Gyeonggido, Seoul, Korea,;9. Department of Internal Medicine, Ewha Women's University College of Medicine, Seoul, Korea,;10. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea,;11. Department of Internal Medicine, Chung Ang University College of Medicine, Seoul, Korea,;12. Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea,;13. University of Ulsan College of Medicine, Seoul, Korea, and;14. Dongguk University College of Medicine, Seoul, Korea
Abstract:
Background and Aim: Capsule endoscopy (CE) has proven to be highly effective at detecting small bowel lesions in a variety of clinical conditions, but studies concerning the practical impact of CE on small bowel tumors are still scarce, especially in the Asian population. The aim of this study was to evaluate the diagnostic and therapeutic impact of CE in the field of small bowel tumors. Methods: CE records consecutively pooled from the beginning of use of CE in Korea, October 2001 until April 2008, in 14 centers throughout Korea were reviewed. Clinical information and CE video images of small bowel tumors were analyzed. Results: A total of 1332 cases undergoing CE were reviewed with all clinical indications. Small bowel tumors were diagnosed with CE in 57 (4.3%) of 1332 patients. The tumors were malignant in 33 cases, and included three adenocarcinomas, eight lymphomas, 20 gastrointestinal stromal tumors, and two metastatic cancers. The most frequent indications for CE in malignant tumors were obscure gastrointestinal bleeding, followed by abdominal pain and weight loss. Thirty of 57 tumors were identified exclusively by CE (diagnostic impact = 30/57), and they were smaller in size (mean, range: 14.3 mm, 2–35 mm) compared to the other tumors detected in radiological studies (48.7 mm, 10–110 mm). Seven patients underwent surgical resection (therapeutic impact = 7/57). Conclusion: CE effectively identifies small bowel tumors that are undetectable by conventional radiological studies (diagnostic impact = 52.6%) and can critically change the therapeutic course (therapeutic impact = 12.3%).
Keywords:capsule endoscopy  small intestine  tumor
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