Incidence of small bowel neoplasia in Lynch syndrome assessed by video capsule endoscopy

Jasmijn F. Haanstra; Abdul Al-Toma; Evelien Dekker; Steven A.L.W Vanhoutvin; Fokko M. Nagengast; Elisabeth M. Mathus-Vliegen; Monique E. van Leerdam; Wouter H. de Vos tot Nederveen Cappel; Roeland A. Veenendaal; Annemieke Cats; Silvia Sanduleanu; Hans F.A. Vasen; Jan H. Kleibeuker; Jan J. Koornstra

doi:10.1055/s-0043-111723

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(07): E622-E626
DOI: 10.1055/s-0043-111723

Original article

Incidence of small bowel neoplasia in Lynch syndrome assessed by video capsule endoscopy

Authors

Jasmijn F. Haanstra

¹Department of gastroenterology and hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

⁷Department of gastroenterology and hepatology, Isala, Zwolle, The Netherlands
Abdul Al-Toma

²Department of gastroenterology and hepatology, St Antonius Hospital, Nieuwegein, The Netherlands
Evelien Dekker

³Department of gastroenterology and hepatology, Amsterdam Medical Center, Amsterdam, The Netherlands
Steven A.L.W Vanhoutvin

⁴Department of gastroenterology and hepatology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), Amsterdam, The Netherlands
Fokko M. Nagengast

⁵Department of gastroenterology and hepatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
Elisabeth M. Mathus-Vliegen

³Department of gastroenterology and hepatology, Amsterdam Medical Center, Amsterdam, The Netherlands
Monique E. van Leerdam

⁴Department of gastroenterology and hepatology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), Amsterdam, The Netherlands

⁶Dept of gastroenterology and hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
Wouter H. de Vos tot Nederveen Cappel

⁷Department of gastroenterology and hepatology, Isala, Zwolle, The Netherlands
Roeland A. Veenendaal

⁸Department of gastroenterology and hepatology, Leiden University Medical Center, Leiden, The Netherlands
Annemieke Cats

⁴Department of gastroenterology and hepatology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), Amsterdam, The Netherlands
Silvia Sanduleanu

⁹Department of gastroenterology and hepatology, Maastricht University Medical Center, Maastricht, The Netherlands
Hans F.A. Vasen

⁸Department of gastroenterology and hepatology, Leiden University Medical Center, Leiden, The Netherlands

¹⁰The Netherlands Foundation for the Detection of Hereditary Tumours, Leiden, The Netherlands
Jan H. Kleibeuker

¹Department of gastroenterology and hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Jan J. Koornstra

¹Department of gastroenterology and hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

Abstract

Background and study aims Lynch syndrome (LS) patients have an increased risk of small bowel cancer. The question is whether surveillance will lead to early detection of (pre)malignant lesions. We recently reported on prevalence of small bowel neoplasia (SBN) in LS patients as assessed by video capsule endoscopy (VCE). The aim of this prospective study was to determine the incidence of SBN.

Patients and methods Asymptomatic LS patients who underwent a VCE were invited to undergo a second VCE procedure 2 years later. If abnormalities or polypoid lesions larger than 1 cm were detected, subsequent endoscopic procedures were performed.

Results A total of 155 (78 %) of the initial 200 patients underwent a second VCE procedure after a mean of 2.2 (range 1 – 6) years. In 17 of the 155 (11 %) patients possibly significant lesions were detected, which required further investigation by means of gastroduodenoscopy (n = 8) or balloon-assisted endoscopy (n = 9). These procedures revealed no SBN.

Conclusion No SBN was found after 2 years. Surveillance of the small bowel by VCE does not seem to be warranted in asymptomatic LS patients.

This study was registered in the Clinical Trials.gov registry with identifier NCT00898768.

Full Text

References

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