Background:

Endoscopic mucosal resection (EMR) of small bowel (SB) lesions may obviate the need for surgery in patients with benign and endoscopically treatable malignant lesions.

Aims:

To report the preliminary experience of the first four cases of EMR of laterally spreading tumors (LSTs) in the SB. The aim of our study was to evaluate the applicability and safety of EMR of LSTs in SB.

Patients and methods:

It was a prospective study (October 2011-2012). Four patients (1 female, 3 males) with a median age of 40,8 with age range 21-50 years were examined. All patients had previous diagnosis of the lesions by capsule endoscopy. All procedures of single balloon enteroscopy (SBE) were performed with sedations (propofol) assisted by anesthesiologist. Indications: anemia, evaluation of Peutz Jeghers, suspicion of tumor. An Olympus SIF 180-Q Enteroscope and CO2 pump UCR were used.

Results:

In 4 patients were performed 5 procedures of SBE. 4 procedures were performed by oral approach and 1 by anal approach. EMR was technically possible in all the lesions..En bloc resection 2 (40%) and piecemeal 3 (60%). The mean diameter was 3.8 cms resected mucosa (3-5 cms). Perforations occurred in 1 case being resolved with combined treatment (endoscopic-laparoscopic). There was no mortality. Histopathological results: adenomas (2), follicular lymphoma (2), hamartoma with laterally spreading (1).

Conclusions:

Our results suggest that the EMR, seems to be a good option for the endoscopic treatment of LSTs in SB. It is a feasible and safe technique. Complication rate was acceptable.