Endoscopy 2019; 51(04): S166
DOI: 10.1055/s-0039-1681661
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 16:30 – 17:00: Small bowel tumors ePoster Podium 8
Georg Thieme Verlag KG Stuttgart · New York

THE ROLE OF ENTEROSCOPY IN THE PREOPERATIVE DIAGNOSIS OF BLEEDING GASTROINTESTINAL STROMAL TUMORS OF THE SMALL INTESTINE

DE Seleznev
1   Medical Center 'Klinika K+31', Moscow, Russian Federation
,
EV Ivanova
2   N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
,
OI Yudin
1   Medical Center 'Klinika K+31', Moscow, Russian Federation
,
EV Tikhomirova
3   Moscow University Hospital №31, Moscow, Russian Federation
,
MA Shumikhina
3   Moscow University Hospital №31, Moscow, Russian Federation
,
ED Fedorov
2   N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Bleeding gastrointestinal stromal tumors (GISTs) of the small bowel (SB) previously were diagnosed late or required open surgery. Video capsule endoscopy (VCE) and balloon-assisted enteroscopy (BAE) change surgical approach for these patients.

Methods:

From II.2007 to XI.2018 we examined 223 patients with suspected SB bleeding and revealed 53 (23.8%) pts. with bleeding SB tumors, including 10 pts. with GISTs (m-4, f-6, ranged 25 – 70 years, mean age 48,7 ± 18,4 years). The indication for examination of the SB in 9 (90,0%) pts. was obscure overt bleeding and in 1 (10%) – obscure occult bleeding. The duration of disease in 5/10 (50%) pts. was more than 3 years; in 5/10 (50%) – less than a year; recurrent bleeding was observed in 6/10 (60%) pts. VCE was carried out in 7/10 (70%) pts.; BAE in 8/10 (80%) pts. (5 – per orally, 2 – transanally and 1 intraoperatively).

Results:

GISTs were located in jejunum in 8/10 (80%) pts., in ileum in 2/10 (20%) pt. GISTs size ranged from 15 to 50 mm (mean size 28,2 ± 11,2 mm). Solitary GISTs were found in all 10 (100%) pts.: in 2/10 (20%) pts. with extra intestinal type of tumor growth; in 1/10 (10%) pt. – intraintestinal type of growth, and in 7 (70%) pts. – intramural type of growth. Resection of the SB with GIST was applied in all 10 (100%) pts.; in 9 (90.0%) of them minimally invasive – laparoscopically (2) or laparoscopically assisted via the mini-laparotomy (7). We found no recurrent bleeding or GISTs in none of 10 patients in the long-term period.

Conclusions:

VCE and BAE considerably improved the diagnosis of bleeding SB GISTs, allowing not only to detect these tumors but to determine their exact localization. In turn, precise diagnosis gave the opportunity to resect SB with GIST laparoscopically or via the minilaparotomy in 90.0% of patients.