Clinical outcomes of endoscopic resection for treating non-ampullary duodenal lesions

doi:10.3877/cma.j.issn.1674-6899.2018.06.013

Abstract

Abstract:

Objective

To analyze the efficacy and safety of endoscopic resection for the treatment of non-ampullary duodenal lesions (NADLs) retrospectively.

Methods

A total of 72 patients diagnosed with NADLs underwent endoscopic resection at the Chinese PLA General Hospital. Data on patient demographics, treatment information and follow-up results were retrospectively analyzed.

Results

Among 72 patients, 36 patients underwent endoscopic mucosal resection (EMR), 22 patients underwent endoscopic submucosal dissection (ESD) and 14 patients underwent modified ESD. The rate of en bloc resection and R0 resection were 83.3% and 79.2%, respectively. Six patients (8.3%) experienced perforation and 5 patients (6.9%) experienced delayed bleeding. Follow-up endoscopy were performed for 68 cases(94.4%) and local recurrence was detected in 8 cases (11.1%), and they all underwent repeated endoscopic intervention.

Conclusions

Endoscopic resection of NADLs is feasible an effective. However, it is associated with high incidence rate of complications owing to the duodenal anatomical peculiarities. Effective methods for preventing complications are necessary.

Key words: Endoscopic surgery, Non-ampullary duodenal lesions

Jiale Zou, Ningli Chai, Yaqi Zhai, Chen Du, Longsong Li, Xiangdong Wang, Ping Tang, Enqiang Linghu. Clinical outcomes of endoscopic resection for treating non-ampullary duodenal lesions[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(06): 364-366.

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https://zhqjwkzz.cma-cmc.com.cn/EN/Y2018/V11/I06/364

References 18

[1]	Goda K, Kikuchi D, Yamamoto Y，et al. Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors in japan: multicenter case series [J]. Dig Endosc，2014，26(2)：23-29.
[2]	Perez A, Saltzman JR, Carr-Locke DL, et al. Benign nonampullary duodenal neoplasms [J]. J Gastrointest Surg，2003，7(4)：536-541.
[3]	Mukherjee S, Kocher HM, Hutchins RR, et al. Impact of hospital volume on outcomes for pancreaticoduodenectomy: a single UK HPB centre experience [J]. Eur J Surg Oncol，2008，35(7)：734-738.
[4]	Cameron JL, Riall TS, Coleman J, et al. One thousand consecutive pancreaticoduodenectomies [J]. Ann Surg，2006，244(1)：10-15.
[5]	孟令威，蔡云强，李永彬，等．腹腔镜胰十二指肠切除术后临床胰瘘危险因素分析[J/CD]．中华腔镜外科杂志(电子版)，2017，10(6)：355-360.
[6]	Jepsen JM, Persson M, Jakobsen NO，et al. Prospective study of prevalence and endoscopic and histopathologic characteristics of duodenal polyps in patients submitted to upper endoscopy [J]. Scand JGastroenterol，1994，29(6)：483-487.
[7]	Galandiuk S, Hermann RE, Jagelman DG，et al. Villous tumors of the duodenum [J]. Ann Surg，1988，207(3)：234-239.
[8]	Perzin KH, Bridge MF. Adenomas of the small intestine: a clinicopathologic review of 51 cases and a study of their relationship to carcinoma [J]. Cancer，1981，48(3)：799-819.
[9]	Delle Fave G, Kwekkeboom DJ, Van Cutsem E, et al. ENETS consensus guidelines for the management of patients with gastroduodenal neoplasms [J]. Neuroendocrinology，2012, 95(2)：74-87.
[10]	Delle Fave G, O′Toole D, Sundin A, et al. ENETS consensus guidelines up- date for gastroduodenal neuroendocrine neoplasms [J]. Neuroendocrinology，2016, 103(2)：119-124.
[11]	Kim DH, Kim KM, Oh SJ，et al.Early gastric cancer arising from heterotopic gastric mucosa in the gastric submucosa [J]. J Korean Surg Soc，2011，80(1)：6-11.
[12]	Iitaka D, Fujiwara H, Shiozaki A，et al.Double primary cancer of the esophagus consisting of ectopic gastric mucosa-derived adenocarcinoma and squamous cell carcinoma: a first case report [J]. Esophagus，2011，8(4)：303-309.
[13]	Orlowska J, Jarosz D, Pachlewski J，et al. Malignant transformation of benign epithelial gastric polyps [J]. Am J Gastroenterol，1995，90(12)：2152-2159.
[14]	Moss A, Bourke MJ, Tran K, et al. Lesion isolation by circumferential submucosal incision prior to endoscopic mucosal resection (CSI-EMR) substantially improves en bloc resection rates for 40mm colonic lesions [J]. Endoscopy, 2010，42(5)：400-404.
[15]	郭花，王海红，李娜，等．胃肠道神经内分泌肿瘤的内镜下诊断与治疗[J]. 胃肠病学和肝病学杂志，2014，23(9)：1010-1014.
[16]	Oda I, Suzuki H, Nonaka S，et al. Complications of gastric endoscopic submucosal dissection [J]. Dig Endosc，2013，25(1)：71-78.
[17]	Matsuda T, Matsuda T, Fujii T，et al. Complete closure of a large defect after EMR of a lateral spreading colorectal tumor when using a two-channel colonoscope [J]. Gastrointest Endosc，2004，60(5)：836-838.
[18]	Hoteya S, Kaise M, Iizuka T，et al. Delayed bleeding after endoscopic submucosal dissection for non-ampullary superficial duodenal neoplasias might be prevented by prophylactic endoscopic closure: analysis of risk factors [J]. Dig Endosc，2015，27(3)：323-330.

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