Short-term results of treatment of non-epithelial gastro-intestinal tumors complicated by bleeding
Abstract
Aim of investigation. To study potentials of modern therapeutic and diagnostic methods in patients with bleeding non-epithelial tumors of the gut.
Material and methods. In 52 patients for assessment of localization, structure and character of proliferation of tumor modern radiological and endoscopic methods were applied: balloon and videocapsular endoscopy, selective angiography, computer tomography, endoscopic ultrasonography with fine-needle biopsy.
Results. According to suggested diagnostic algorithm detailed characteristic of patients with bleeding tumor was given, the optimal method of surgical intervention was chosen. In 13 (25%) of patients primary endoscopic hemostasis was carried out. Thirty five patients were operated (67,3%), and in 8 (22,8%) of them endoscopic erasion of bleeding non-epithelial tumor was carried out. In 4 cases (7,7%) intraoperative complications developed, after operation 1 patient (2,9%) died of pulmonary artery thrombembolism, overall mortality was 3,8% (2/52).
Conclusions. Non-epithelial tumor of gut in 29,1% of patients are complicated by gastro-intestinal bleeding that is indication for surgical treatment. Proposed algorithm of diagnostics and treatment, that includes primary endoscopic hemostasis allows to avoid urgent intervention in 94,3% of patients and to execute it in the late stage, while in 22,8% to carry out noninvasive intraluminal surgery as a final treatment.
About the Authors
S. G. ShapovalyantsRussian Federation
A. I. Mikhalev
Russian Federation
Ye. D. Fedorov
Russian Federation
R. V. Plakhov
Russian Federation
L. M. Mikhaleva
Russian Federation
Z. V. Galkova
Russian Federation
Ye. V. Ivanova
Russian Federation
A. E. Sergeyenko
Russian Federation
References
1. Воробей А.В., Климович В.В. Неязвенные гастроинтестинальные кровотечения. – Минск: ПОЛИПРИНТ, 2008. – 228 с.
2. Галкин В.Н., Майстренко Н.А. Диагностика и хирургическое лечение неэпителиальных опухолей желудочнокишечного тракта // Хирургия. Журнал им. Н.И. Пирогова. – 2003. – № 3. – С. 34–38.
3. Дуболазова Ю.В., Ивашкин В.Т., Напалкова Н.Н. и др. Современные подходы к диагностике и лечению лейомиом желудка: данные литературы и описание собственного наблюдения // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2008. – Т. 18, № 6. – С. 81–87.
4. Константинова М.М. Гастроинтестинальные стромальные опухоли (GIST). Стандарты диагностики и тактики лечения // Вестник Московского Онкологического Общества. – 2005. – № 11. – С. 2–3.
5. Корнилов Ю.М., Овсянникова И.А. Эндоскопическая диагностика и лечение подслизистых опухолей пищевода, желудка и двенадцатиперстной кишки // Альманах эндоскопии. – 2002. – № 1. – С. 56–60.
6. Поддубная И.В. Гастроинтестинальные стромальные опухоли (диагностика, лечение) // Практические рекомендации. – М., 2008. – 53 с.
7. Старков Ю.Г., Солодилина Е.Н., Новожилова А.В. Подслизистые новообразования желудочно-кишечного тракта в эндоскопической практике (обзор) // Хирургия. Журнал им. Н.И. Пирогова. – 2010. – № 2. – С. 51–59.
8. Федоров Е.Д., Иванова Е.В., Юдин О.И. и др. Диагностические и лечебные возможности глубокой баллонной энтероскопии // Дальневосточный медицинский журнал. – 2010. – № 1. – С. 32–37.
9. Ando N., Goto H., Niwa Y. et al. The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis // Gastrointest. Endosc. – 2002. – N 55. – Р. 37–43.
10. Arahoshi K., Sumida Y., Matsui N. et al. Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration // World J. Gastroenterol. – 2007. – Vol. 14. – P. 2077–2082.
11. Giovannini M., Seitz J.F., Monges G. et al. Fine needle aspiration cytology guided by endoscopic ultrasonography: results in 141 patients // Endoscopy. – 1995. – Vol. 27. – P. 171–177.
12. Gluszek S., Karcz W., Matykiewicz J. et al. Gastrointestinal stromal tumors // Gastroenterol. Pol. – 2004. – Vol. 11. – P. 17–21.
13. Lewis B., Swain P. Capsule Endoscopy in the evaluation of patients with suspected small intestinal bleeding: the results of the first clinical trial // Gastrointest. Endoscopy. – 2001. – Vol. 53: Abstract 70.
14. Hawes R.H., Fockens P. Endosonography. – Elsevier Ink., 2006. – 329 p.
15. Nichimura J., Nakajama K., Omori T. et al. Surgical strategy for gastrointestinal stromal tumors: laparoscopic vs. open resection // Surg. Endosc. – 2007. – Vol. 21. – P. 875–878.
Review
For citations:
Shapovalyants S.G., Mikhalev A.I., Fedorov Ye.D., Plakhov R.V., Mikhaleva L.M., Galkova Z.V., Ivanova Ye.V., Sergeyenko A.E. Short-term results of treatment of non-epithelial gastro-intestinal tumors complicated by bleeding. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2011;21(5):35-40. (In Russ.)
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