The role of endoscopic intervention for diagnosis and treatment of submucosal tumor in the small bowel

Backgrounds: It is sometimes challenging to obtain the pathological results for small bowel submucosal tumors (SMTs) before treatment. The aim of this study was to retrospectively evaluate the SMTs in the patients and discuss the role of endoscopy.
Patients and Methods: SMTs were diagnosed by DBE in 118 patients in our hospital, including 78 males. Mean age of the patients was 61 ± 9 years old. Indications of endoscopic intervention in our hospital: 1) small bowel tumor which could not be diagnosed accurately only by endoscopic image or endoscopic ultrasonography, 2) biopsy negative, 3) applicable view at the lesion site available for endoscopic intervention, 4) EMR : tumor with less than 10mm in size except for lipoma, and 5) clinical benefit of treatment. We reviewed the details of endoscopic procedures. Results: SMTs were 39 gastrointestinal stromal tumor, 22 metastatic tumor, 13 ectopic pancreas, 10 hemangioma, 9 lipoma, 7 lymphangioma, 8 neuroendocrine tumor, 6 leiomyoma, 3 pyogenic granuloma, and 1 inflammatory fibroid polyp. Biopsy positive rate was 71.8% (46/64 performed cases). Diagnostic resection using EMR was performed in 2 lesions, which were obtained conformed diagnoses. Endoscopic treatment was performed in 19 of 107 patients (17.7%). Histopathological result was positive in 18 of those 19 patients (94.7%). Conclusions: Endoscopic intervention for SMTs was feasible and safe.