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.

Keywords

• gastro-intestinal bleeding
• non-epithelial tumor
• gastrointestinal stromal tumor
• endoscopic ultrasonography
• enteroscopy