Capsule endoscopy in small bowel tumors: a multicenter Korean study.
OBJECTIVE
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).


CONCLUSIONS
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%).
Cheung
Dae Young
DY
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Lee
In-Seok
IS
Chang
Dong Kyung
DK
Kim
Jin Oh
JO
Cheon
Jae Hee
JH
Jang
Byung Ik
BI
Kim
Yong-Sik
YS
Park
Cheol Hee
CH
Lee
Kwang Jae
KJ
Shim
Ki-Nam
KN
Ryu
Ji-Kon
JK
Do
Jae-Hyuk
JH
Moon
Jeong-Seop
JS
Ye
Byong Duk
BD
Kim
Kyung-Jo
KJ
Lim
Yun Jeong
YJ
Choi
Myung-Gyu
MG
Chun
Hoon-Jai
HJ
D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D015994:Incidence; D007421:Intestine, Small; D007580:Jejunal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D007723:Korea / Q000453:epidemiology; D008223:Lymphoma / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies