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Endoscopy 2022; 54(07): 663-670
DOI: 10.1055/a-1640-3236
Original article

Outcomes of endoscopic resection for superficial duodenal tumors: 10 years’ experience in 18 Japanese high volume centers

Motohiko Kato 
 1   Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
,
Yoji Takeuchi
 2   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Shu Hoteya
 3   Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Tsuneo Oyama
 4   Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan
,
Satoru Nonaka
 5   Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
,
Shoichi Yoshimizu 
 6   Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
,
Naomi Kakushima
 7   Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
,
Ken Ohata
 8   Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, Tokyo, Japan
,
Hironori Yamamoto 
 9   Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Yuko Hara
10   Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
,
Hisashi Doyama
11   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Osamu Dohi
12   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Yasushi Yamasaki 
13   Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
,
Hiroya Ueyama 
14   Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
,
Kengo Takimoto
15   Department of Gastroenterology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
,
Koichi Kurahara
16   Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan
,
Tomoaki Tashima
17   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Nobutsugu Abe
18   Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan
,
Atsushi Nakayama
 1   Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
,
Ichiro Oda
 5   Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
,
Naohisa Yahagi
 1   Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
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The application of underwater endoscopic mucosal resection for superficial duodenal tumorsEndoscopy 2023; 55(07): 683-683
DOI: 10.1055/a-2038-3538

Abstract

Background Data on endoscopic resection (ER) for superficial duodenal epithelial tumors (SDETs) are insufficient owing to their rarity. There are two main ER techniques for SDETs: endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). In addition, modified EMR techniques, such as underwater EMR (UEMR) and cold polypectomy, are becoming popular. We conducted a large-scale retrospective multicenter study to clarify the detailed outcomes of duodenal ER.

Methods Patients with SDETs who underwent ER at 18 institutions from January 2008 to December 2018 were included. The rates of en bloc resection and delayed adverse events (AEs; defined as delayed bleeding or perforation) were analyzed. Local recurrence was analyzed using the Kaplan–Meier method.

Results In total, 3107 patients (including 1017 undergoing ESD) were included. En bloc resection rates were 79.1 %, 78.6 %, 86.8 %, and 94.8 %, and delayed AE rates were 0.5 %, 2.2 %, 2.8 %, and 6.8 % for cold polypectomy, UEMR, EMR and ESD, respectively. The delayed AE rate was significantly higher in the ESD group than in non-ESD groups for lesions < 19 mm (7.4 % vs. 1.9 %; P < 0.001), but not for lesions > 20 mm (6.1 % vs. 7.1 %; P = 0.64). The local recurrence rate was significantly lower in the ESD group than in the non-ESD groups (P < 0.001). Furthermore, for lesions > 30 mm, the cumulative local recurrence rate at 2 years was 22.6 % in the non-ESD groups compared with only 1.6 % in the ESD group (P < 0.001).

Conclusions ER outcomes for SDETs were generally acceptable. ESD by highly experienced endoscopists might be an option for very large SDETs.

Supplementary material



Publication History

Received: 26 January 2021

Accepted: 08 September 2021

Accepted Manuscript online:
08 September 2021

Article published online:
28 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Letter to this article:

Endoscopic treatment selection for superficial duodenal tumors: pay attention to small lesionsEndoscopy 2022; 54(05): 522-522
DOI: 10.1055/a-1669-8779

 

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