Application Value Of BAE In Diagnosis And Treatment Of Small Bowel Tumor

Background and Objective:Primary small intestine tumors with low incidence accounts for 5% of the entire gastrointestinal tumors,and half of them were malignant, accounting for 2% of the entire gastrointestinal tract malignant tumor [1].Small bowel tumors are usually with occult onset and clinical manifestations are not specific. Because of the anatomic features of the small intestine, the diagnosis of imaging examination methods like gastrointestinal barium radiography, abdominal CT scan and capsule endoscopy (CE) have some shortcomings and the early diagnosis of small bowel tumors is difficult. The appearance of balloon-assisted enteroscopy (BAE) provides a novel approach for the diagnosis of this disease. Clinical application shows that the diagnosis of BAE has a higher rate in small intestinal tumors[2-5] But the related research is rarely reported, especially for the treatment of small intestinal tumor by BAE at home and abroad[6-11]. its clinical utility, safety still need further verification[12-13]. The purpose of this study was to verify the application value of BAE in diagnosis, treatment and safety in small intestinal tumor.Methods:From May 2007 to September 2014, a total of 126 patients with suspected small bowel tumor were enrolled. BAE was performed in all patients. Of them,80 patients also underwent abdominal CT scan,22 patients underwent gastrointestinal barium radiography, and 24 patients underwent capsule endoscopy. The positive detection rate, sensitivity, specificity, and the rates of missed diagnosis and misdiagnosis of different examinations were compared. The tolerance, related complications and disease remission atter treatment were observed in some patients with small intestinal tumor who underwent the treatment of balloon-assisted enteroscopy to comprehensively evaluate the feasibility and safety of balloon-assisted endoscopy in the diagnosis and treatment of small intestinal tumor. All data were analysised statistically by SPSS 17.0. Rates of the groups were compared withχ2 test, the difference would be significant if P<0.05.Results:The positive rate, sensitivit y and specificity of BAE for suspected small bowel tumor were significantly higher than abdominal CT scan, gastrointestinal barium radiography and CE (The positive rates of balloon-assisted enteroscopy, abdominal CT, gastrointestinal barium, capsule endoscopy respectively were:92.9%,47.5%,68.2%, 91.7%; the sensitivity were:100%,71.1%,66.7%,100%; specificity were:100%,82.9%, 28.6%,22.2%)(P<0.01), while the rates of missed diagnosis and misdiagnosis were remarkably decreased (The rate of missed diagnosis of Balloon assisted enteroscopy, abdominal CT, gastrointestinal barium, capsule endoscopy were:0%,28.9%,33.3%, 0%; the rate of misdiagnosis were:0%,17.1%,71.4%,77.8%) (P<0.01).27 cases of small intestinal benign tumors underwent endoscopic therapy by balloon assisted enteroscopy and all patients have been effectively alleviate the condition. All patients haven’t got aspiration, gastrointestinal bleeding, gastrointestinal perforation and other complications in the therapy by balloon-assisted enteroscopy, only a few individuals complained about the postoperative mild discomfort and pain of throat, anal and abdomen but all the symptoms were easy to ease.Conclusion:BAE has a high positive detection rate, sensitivity and specificity in the diagnosis of small bowel tumor. It is safe and reliable for endoscopic therapy for partial small bowel tumor. It can effectively avoid the trauma caused by surgery in patient’s body and has a high clinical application value.