Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors
Prediction of histology by endoscopic examination is important in the clinical management of non-ampullary duodenal epithelial tumors (NADETs), including adenoma and adenocarcinoma. The use of a simple scoring system based on the findings of white-light endoscopy or magnified endoscopy with narrow-b...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2020-11-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2019-184.pdf |
| _version_ | 1827610181301698560 |
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| author | Naomi Kakushima Masao Yoshida Yohei Yabuuchi Noboru Kawata Kohei Takizawa Yoshihiro Kishida Sayo Ito Kenichiro Imai Kinichi Hotta Hirotoshi Ishiwatari Hiroyuki Matsubayashi Hiroyuki Ono |
| author_facet | Naomi Kakushima Masao Yoshida Yohei Yabuuchi Noboru Kawata Kohei Takizawa Yoshihiro Kishida Sayo Ito Kenichiro Imai Kinichi Hotta Hirotoshi Ishiwatari Hiroyuki Matsubayashi Hiroyuki Ono |
| author_sort | Naomi Kakushima |
| collection | DOAJ |
| description | Prediction of histology by endoscopic examination is important in the clinical management of non-ampullary duodenal epithelial tumors (NADETs), including adenoma and adenocarcinoma. The use of a simple scoring system based on the findings of white-light endoscopy or magnified endoscopy with narrow-band imaging is useful to differentiate between Vienna category 3 (C3) and C4/5 lesions. Less invasive endoscopic resection procedures, such as cold snare polypectomy, are quick to perform and convenient for small (<10 mm) C3 lesions. Neoplasms with higher grade histology, such as C4/5 lesions, should be treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or surgery. Although EMR often requires piecemeal resection, the complication rate is acceptable. Excellent complete resection rates could be achieved by ESD; however, it remains a challenging method considering the high risk of complications. Shielding or closure of the ulcer after ESD is effective at decreasing the risk of delayed bleeding and perforation. Laparoscopic endoscopic cooperative surgery is an ideal treatment with a high rate of en bloc resection and a low rate of complications, although it is limited to high-volume centers. Patients with NADETs could benefit from a multidisciplinary approach to stratify the optimal treatment based on endoscopic diagnoses. |
| first_indexed | 2024-03-09T07:45:16Z |
| format | Article |
| id | doaj.art-38bc6ff96922494f85e3b2fb6124990c |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T07:45:16Z |
| publishDate | 2020-11-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-38bc6ff96922494f85e3b2fb6124990c2023-12-03T03:32:23ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432020-11-0153665265810.5946/ce.2019.1847317Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial TumorsNaomi Kakushima0Masao Yoshida1Yohei Yabuuchi2Noboru Kawata3Kohei Takizawa4Yoshihiro Kishida5Sayo Ito6Kenichiro Imai7Kinichi Hotta8Hirotoshi Ishiwatari9Hiroyuki Matsubayashi10Hiroyuki Ono11 Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, JapanPrediction of histology by endoscopic examination is important in the clinical management of non-ampullary duodenal epithelial tumors (NADETs), including adenoma and adenocarcinoma. The use of a simple scoring system based on the findings of white-light endoscopy or magnified endoscopy with narrow-band imaging is useful to differentiate between Vienna category 3 (C3) and C4/5 lesions. Less invasive endoscopic resection procedures, such as cold snare polypectomy, are quick to perform and convenient for small (<10 mm) C3 lesions. Neoplasms with higher grade histology, such as C4/5 lesions, should be treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or surgery. Although EMR often requires piecemeal resection, the complication rate is acceptable. Excellent complete resection rates could be achieved by ESD; however, it remains a challenging method considering the high risk of complications. Shielding or closure of the ulcer after ESD is effective at decreasing the risk of delayed bleeding and perforation. Laparoscopic endoscopic cooperative surgery is an ideal treatment with a high rate of en bloc resection and a low rate of complications, although it is limited to high-volume centers. Patients with NADETs could benefit from a multidisciplinary approach to stratify the optimal treatment based on endoscopic diagnoses.http://www.e-ce.org/upload/pdf/ce-2019-184.pdfendoscopic mucosal resectionendoscopic submucosal dissectionlaparoscopic endoscopic cooperative surgerynonampullary duodenal epithelial tumors |
| spellingShingle | Naomi Kakushima Masao Yoshida Yohei Yabuuchi Noboru Kawata Kohei Takizawa Yoshihiro Kishida Sayo Ito Kenichiro Imai Kinichi Hotta Hirotoshi Ishiwatari Hiroyuki Matsubayashi Hiroyuki Ono Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors Clinical Endoscopy endoscopic mucosal resection endoscopic submucosal dissection laparoscopic endoscopic cooperative surgery nonampullary duodenal epithelial tumors |
| title | Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors |
| title_full | Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors |
| title_fullStr | Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors |
| title_full_unstemmed | Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors |
| title_short | Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors |
| title_sort | present status of endoscopic submucosal dissection for non ampullary duodenal epithelial tumors |
| topic | endoscopic mucosal resection endoscopic submucosal dissection laparoscopic endoscopic cooperative surgery nonampullary duodenal epithelial tumors |
| url | http://www.e-ce.org/upload/pdf/ce-2019-184.pdf |
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