CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(03): E354-E359
DOI: 10.1055/a-0998-3708
Original article
Owner and Copyright © Georg Thieme Verlag KG 2020

Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumors

Kazutaka Kuroki
1  Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
,
Yoji Sanomura
2  Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
,
Shiro Oka
1  Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
,
Naoki Yorita
1  Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
,
Mio Kurihara
1  Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
,
Takeshi Mizumoto
1  Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
,
Yoshikazu Yoshifuku
1  Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
,
Koji Arihiro
3  Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
,
Shinji Tanaka
2  Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
,
Kazuaki Chayama
1  Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
› Author Affiliations
Further Information

Publication History

submitted 05 June 2018

accepted after revision 05 February 2019

Publication Date:
21 February 2020 (online)

Abstract

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.