USE OF DOUBLE-BALLOON ENTEROSCOPY IN MANAGEMENT OF NEUROENDOCRINE SMALL BOWEL TUMOUR: CASE SERIES FROM NATIONAL TERTIARY REFERRAL CENTRE

A Telese; A Murino; N Lazaridis; D Costa; F Laskaratos; T Luong; N Koukias; D Mandair; C Toumpanakis; M Caplin; EJ Despott

doi:10.1055/s-0039-1681663

Endoscopy, Table of Contents

Endoscopy 2019; 51(04): S167
DOI: 10.1055/s-0039-1681663

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

USE OF DOUBLE-BALLOON ENTEROSCOPY IN MANAGEMENT OF NEUROENDOCRINE SMALL BOWEL TUMOUR: CASE SERIES FROM NATIONAL TERTIARY REFERRAL CENTRE

A Telese

¹The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Royal Free Unit for Endoscopy, London, United Kingdom

,

A Murino

¹The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Royal Free Unit for Endoscopy, London, United Kingdom

,

N Lazaridis

¹The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Royal Free Unit for Endoscopy, London, United Kingdom

,

D Costa

¹The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Royal Free Unit for Endoscopy, London, United Kingdom

,

F Laskaratos

²The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Neuroendocrine Tumour Unit, ENETS Centre of Excellence, London, United Kingdom

,

T Luong

³The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Department of Cellular Pathology, London, United Kingdom

,

N Koukias

¹The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Royal Free Unit for Endoscopy, London, United Kingdom

,

D Mandair

²The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Neuroendocrine Tumour Unit, ENETS Centre of Excellence, London, United Kingdom

,

C Toumpanakis

²The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Neuroendocrine Tumour Unit, ENETS Centre of Excellence, London, United Kingdom

,

M Caplin

²The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Neuroendocrine Tumour Unit, ENETS Centre of Excellence, London, United Kingdom

,

EJ Despott

¹The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Royal Free Unit for Endoscopy, London, United Kingdom

› Author Affiliations

Abstract

Full Text

Aims:

Small bowel (SB) neuroendocrine tumours (SBNETs) are heterogeneous neoplasms which may present good prognosis when identified at early stage. Prompt diagnosis is crucial for successful management however it may be challenging if the lesion is difficult to access. Double-balloon enteroscopy (DBE) enables direct small bowel mucosa visualisation and endotherpy allowing precise lesion sampling and histological diagnosis. The aim of this study was to evaluate the role of DBE in the assessment and management of SBNETs.

Methods:

Retrospective review of SBNETs evaluated and diagnosed using DBE at our institution (November 2016 – November 2018). Demographic, endoscopic, histopathological data were collected and analysed.

Results:

A total of seven patients were included (mean age: 53 (S.D.± 13.1) years) in the study. Six patients (85.7%) presented with obscure-overt mid-gut bleeding or iron deficiency anaemia, one patient was asymptomatic. Both anterograde (n = 3) and retrograde (n = 4) route enabled assessment of the lesions, which were all located in the ileum. A reference submucosal tattoo of sterile carbon ink was placed few cm close to the lesions and multiple biopsies were taken; histopathology was diagnostic in all cases. A total of 5 patents had surgery (n = 4 small bowel resection, n = 1 right hemicolectomy with distal pancreatectomy) and further analysis of the surgical specimens showed a total of 15 SBNETs (mean lesion dimension: 8.1 (S.D.± 3.9)mm, mean number/patient: 3 (S.D.± 1.8).. Histopathological analysis showed well-differentiated grade 1 SBNET (n = 13; 86.6%), well-differentiated grade 2 SBNET (n = 2; 13.3%).

Conclusions:

DBE is essential in SBNETs pre-surgical assessment allowing for lesion sampling and tattoo marking which may be useful to guide minimally invasive surgical resection.