Clinical outcome of endoscopic resection for nonampullary duodenal tumors

DOI PDF PubMed 被引用文献4件
  • Satoru Nonaka
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Ichiro Oda
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Kazuhiro Tada
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Genki Mori
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Yoshinori Sato
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Seiichiro Abe
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Haruhisa Suzuki
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Shigetaka Yoshinaga
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Takeshi Nakajima
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Takahisa Matsuda
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Hirokazu Taniguchi
    Pathology Division, National Cancer Center Hospital, Tokyo, Japan
  • Yutaka Saito
    Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • Iruru Maetani
    Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan

書誌事項

公開日
2014-10-14
DOI
  • 10.1055/s-0034-1390774
公開者
Georg Thieme Verlag KG

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説明

Compared with any other location in the gastrointestinal tract, the duodenum presents the most challenging site for endoscopic resection. The aim of this study was to analyze the clinical outcomes of duodenal endoscopic resection and to assess the feasibility of the technique as a therapeutic procedure.A total of 113 consecutive patients with 121 nonampullary duodenal tumors underwent endoscopic resection by endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), or polypectomy between January 2000 and September 2013. Long-term outcomes were investigated in patients with more than 1 year follow-up.The median tumor size was 12 mm (range 3 - 50 mm). Lesions consisted of 63 adenocarcinomas/high-grade intraepithelial neoplasias (53 %) and 57 adenomas/low-grade intraepithelial neoplasias (48 %). Endoscopic resection included 106 EMRs (87 %), 8 ESDs (7 %), and 7 polypectomies (6 %). En bloc resection was achieved in 77 lesions (64 %), and 43 lesions (35 %) underwent piecemeal resection; one procedure was discontinued due to perforation. There were 14 cases of delayed bleeding after EMR (12 %), 1 perforation (1 %) during ESD, and 1 delayed perforation (1 %) after ESD, which required emergency surgery. Of the 76 patients who were followed for more than 1 year, none of the patients died from a primary duodenal neoplasm, and there were no local recurrences during the 51-month median follow-up period (range 12 - 163 months).Duodenal endoscopic resection was feasible as a therapeutic procedure, but it should only be performed by highly skilled endoscopists because of its technical difficulty. Piecemeal resection by EMR is acceptable for small lesions, based on these excellent long-term outcomes.

収録刊行物

  • Endoscopy

    Endoscopy 47 (02), 129-135, 2014-10-14

    Georg Thieme Verlag KG

被引用文献 (4)*注記

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