Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumors
Background and study aims Because superficial non-ampullary duodenal epithelial tumors (SNADETs) are relatively rare, studies evaluating the outcomes of endoscopic resection (ER) for SNADETs are limited. Therefore, this study aimed to evaluate the clinical validity of ER for SNADETs. Pati...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2020-02-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-0998-3708 |
| _version_ | 1818962256453435392 |
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| author | Kazutaka Kuroki Yoji Sanomura Shiro Oka Naoki Yorita Mio Kurihara Takeshi Mizumoto Yoshikazu Yoshifuku Koji Arihiro Shinji Tanaka Kazuaki Chayama |
| author_facet | Kazutaka Kuroki Yoji Sanomura Shiro Oka Naoki Yorita Mio Kurihara Takeshi Mizumoto Yoshikazu Yoshifuku Koji Arihiro Shinji Tanaka Kazuaki Chayama |
| author_sort | Kazutaka Kuroki |
| collection | DOAJ |
| description | Background and study aims Because superficial non-ampullary duodenal epithelial tumors (SNADETs) are relatively rare, studies evaluating the outcomes of endoscopic resection (ER) for SNADETs are limited. Therefore, this study aimed to evaluate the clinical validity of ER for SNADETs.
Patients and methods The study participants included 163 consecutive patients (108 men; mean age, 61.5 ± 11.3 years) with 171 SNADETs, excluding patients with familial adenomatous polyposis resected by ER, at Hiroshima University Hospital between May 2005 and September 2016. Clinicopathological features and the outcomes of ER for 171 cases were retrospectively analyzed. Additionally, the prognosis of 135 patients with more than 12 months’ follow-up was analyzed.
Results Mean diameter of SNADETs was 10.7 ± 7.2 mm. Most of the SNADET cases were classified as category 3 (71 %, 121/171), but some were category 5 (2 %, 3/171). En bloc resection rates were 93 % (146/157), 100 % (7/7), and 86 % (6/7) in endoscopic mucosal resection (EMR), polypectomy, and in endoscopic submucosal dissection (ESD) cases, respectively. Complete resection rates were 90 % (141/157), 100 % (7/7), and 71 % (5/7) in EMR, polypectomy, and ESD cases, respectively. Emergency surgery was performed in two patients with intraoperative perforation and in two with delayed perforation without artificial ulcer bed closure after ER. Since endoscopic closure of ulcer by clipping was performed, delayed perforation has not occurred. Local recurrence occurred in 1.2 %, but no metastasis to lymph nodes or other organs occurred after ER. No patient died of primary SNADETs.
Conclusion Our data supported the clinical validity of ER for SNADETs. However, delayed perforation should be given much attention. |
| first_indexed | 2024-12-20T12:26:26Z |
| format | Article |
| id | doaj.art-ff636284471f4eee8d85de4108974195 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-20T12:26:26Z |
| publishDate | 2020-02-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-ff636284471f4eee8d85de41089741952022-12-21T19:40:51ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362020-02-010803E354E35910.1055/a-0998-3708Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumorsKazutaka Kuroki0Yoji Sanomura1Shiro Oka2Naoki Yorita3Mio Kurihara4Takeshi Mizumoto5Yoshikazu Yoshifuku6Koji Arihiro7Shinji Tanaka8Kazuaki Chayama9Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, JapanDepartment of Endoscopy, Hiroshima University Hospital, Hiroshima, JapanDepartment of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, JapanDepartment of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, JapanDepartment of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, JapanDepartment of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, JapanDepartment of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, JapanDepartment of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, JapanDepartment of Endoscopy, Hiroshima University Hospital, Hiroshima, JapanDepartment of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, JapanBackground and study aims Because superficial non-ampullary duodenal epithelial tumors (SNADETs) are relatively rare, studies evaluating the outcomes of endoscopic resection (ER) for SNADETs are limited. Therefore, this study aimed to evaluate the clinical validity of ER for SNADETs. Patients and methods The study participants included 163 consecutive patients (108 men; mean age, 61.5 ± 11.3 years) with 171 SNADETs, excluding patients with familial adenomatous polyposis resected by ER, at Hiroshima University Hospital between May 2005 and September 2016. Clinicopathological features and the outcomes of ER for 171 cases were retrospectively analyzed. Additionally, the prognosis of 135 patients with more than 12 months’ follow-up was analyzed. Results Mean diameter of SNADETs was 10.7 ± 7.2 mm. Most of the SNADET cases were classified as category 3 (71 %, 121/171), but some were category 5 (2 %, 3/171). En bloc resection rates were 93 % (146/157), 100 % (7/7), and 86 % (6/7) in endoscopic mucosal resection (EMR), polypectomy, and in endoscopic submucosal dissection (ESD) cases, respectively. Complete resection rates were 90 % (141/157), 100 % (7/7), and 71 % (5/7) in EMR, polypectomy, and ESD cases, respectively. Emergency surgery was performed in two patients with intraoperative perforation and in two with delayed perforation without artificial ulcer bed closure after ER. Since endoscopic closure of ulcer by clipping was performed, delayed perforation has not occurred. Local recurrence occurred in 1.2 %, but no metastasis to lymph nodes or other organs occurred after ER. No patient died of primary SNADETs. Conclusion Our data supported the clinical validity of ER for SNADETs. However, delayed perforation should be given much attention.http://www.thieme-connect.de/DOI/DOI?10.1055/a-0998-3708 |
| spellingShingle | Kazutaka Kuroki Yoji Sanomura Shiro Oka Naoki Yorita Mio Kurihara Takeshi Mizumoto Yoshikazu Yoshifuku Koji Arihiro Shinji Tanaka Kazuaki Chayama Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumors Endoscopy International Open |
| title | Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumors |
| title_full | Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumors |
| title_fullStr | Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumors |
| title_full_unstemmed | Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumors |
| title_short | Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumors |
| title_sort | clinical outcomes of endoscopic resection for superficial non ampullary duodenal tumors |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-0998-3708 |
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