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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(05): E659-E666
DOI: 10.1055/a-1374-6141
Original article

Endoscopic resection using an over-the-scope clip for duodenal neuroendocrine tumors

Tomoaki Tashima
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Shomei Ryozawa
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Yuki Tanisaka
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Akashi Fujita
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Kazuya Miyaguchi
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Tomoya Ogawa
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Masafumi Mizuide
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Yumi Mashimo
1   Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
,
Tomonori Kawasaki
2   Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan
,
Masami Yasuda
2   Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan
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Abstract

Background and study aims Endoscopic resection of duodenal neuroendocrine tumors (DNETs) remains controversial, and its indications are still unclear. This study aimed to evaluate short-term outcomes of a newly developed endoscopic muscularis resection (EMR) method that utilizes an over-the-scope clip (OTSC), termed EMRO, for treating DNETs.

Patients and methods In total, 13 consecutive patients with 14 small (≤ 10 mm) DNETs who underwent EMRO from September 2017 to March 2020 were retrospectively enrolled. EMRO was performed by a single experienced endoscopist. Patients’ characteristics and treatment outcomes were assessed.

Results The En bloc and R0 resection rates were 100 % (14/14) and 92.9 % (13/14), respectively. The median pathological resected specimen size was 10 mm, with a median pathological resected tumor size of 6 mm. During the EMRO procedure, there was no occurrence of misplacement of the OTSC to the target lesion. With respect to the pathological resection depth, nine cases (64.3 %) and five cases (35.7 %) were categorized as deep submucosal resection and muscularis resection, respectively, whereas no case was categorized as full-thickness resection. There were no intraoperative or delayed perforations. However, delayed bleeding occurred in two cases. At a median follow-up of 12 months (range 7–36) after EMRO, there was no incidence of local recurrence. At the first follow-up endoscopy performed at 6 months after EMRO, the OTSC was retained in place in two of 14 DNETs (14.3 %).

Conclusions EMRO can be performed safely, by an experienced endoscopist, for small (≤ 10 mm) DNETs.



Publication History

Received: 17 September 2020

Accepted: 20 January 2021

Article published online:
22 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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