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Endoscopy 2021; 53(10): 1065-1068
DOI: 10.1055/a-1327-5939
Innovations and brief communications

Safety and feasibility of laparoscopic and endoscopic cooperative surgery for duodenal neoplasm: a retrospective multicenter study

Souya Nunobe
 1   Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, Tokyo, Japan
,
Motonari Ri
 1   Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, Tokyo, Japan
,
Kimiyasu Yamazaki
 2   Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
,
Masanao Uraoka
 3   Department of Endoscopy, Kishiwada Tokusyukai Hospital, Osaka, Japan
,
Ken Ohata
 4   Department of Endoscopy, NTT Medical Center Tokyo, Tokyo, Japan
,
Iwao Kitazono
 5   Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
,
Masanori Terashima
 6   Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan
,
Yukinori Yamagata
 7   Department of Gastric Surgery, National Cancer Center Hospital, Tokyo, Japan
,
Satoshi Tanabe
 8   Department of Advanced Medicine Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan
,
Nobutsugu Abe
 9   Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan
,
Toshikatsu Tsuji
10   Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
,
Keiko Niimi
11   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Hirofumi Kawakubo
12   Department of Surgery, Keio University School of Medicine, Tokyo, Japan
,
Tomoya Tsukada
13   Department of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan
,
Shuji Kitashiro
14   Department of Surgery, Tonan Hospital, Sapporo, Japan
,
Naoki Ishizuka
15   Department of Clinical Trial Planning and Management, Cancer Institute Ariake Hospital, Tokyo, Japan
,
Naoki Hiki
16   Department of Upper Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan
,
Society for the Study of Laparoscopic Endoscopic Cooperative Surgery › Author Affiliations
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Author commentary on Souya Nunobe et al.Endoscopy 2021; 53(10): v52-v52
DOI: 10.1055/a-1347-8104

Referred to by:

Is it really necessary to achieve R0 resection in duodenal superficial lesions? If yes, does it justify surgery?Endoscopy 2021; 53(10): 1069-1070
DOI: 10.1055/a-1467-6401

Abstract

Background A delayed perforation can often occur after endoscopic treatment for duodenal neoplasms and may be fatal due to leakage of pancreatic and bile juices. We aimed to evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery for duodenal neoplasms (D-LECS) in a multicenter, retrospective study.

Methods The clinical characteristics and surgical outcomes of 206 patients with duodenal neoplasms in whom D-LECS had initially been attempted at one of 14 institutions were reviewed retrospectively.

Results Of the 206 patients, 63 (30.6 %), 128 (62.1 %), and 15 patients (7.3 %) had lesions at the bulb, second portion, and third portion of the duodenum, respectively. The rates of en bloc and R0 resections during D-LECS were 96.1 % and 95.1 %, respectively. Intraoperative and delayed perforations occurred in 10 (4.9 %) and 5 patients (2.4 %), respectively. No cases of recurrence were observed. Surgical duration of ≥ 180 minutes was an independent risk factor for postoperative complications.

Conclusions The results revealed that D-LECS was performed with oncological safety and technical feasibility.

Supplementary material



Publication History

Received: 21 May 2020

Accepted after revision: 02 December 2020

Accepted Manuscript online:
02 December 2020

Article published online:
04 February 2021

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