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

Tomoaki Tashima; Shomei Ryozawa; Yuki Tanisaka; Akashi Fujita; Kazuya Miyaguchi; Tomoya Ogawa; Masafumi Mizuide; Yumi Mashimo; Tomonori Kawasaki; Masami Yasuda

doi:10.1055/a-1374-6141

Endoscopy International Open, Table of Contents

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

¹Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan

,

Shomei Ryozawa

¹Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan

,

Yuki Tanisaka

¹Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan

,

Akashi Fujita

¹Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan

,

Kazuya Miyaguchi

¹Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan

,

Tomoya Ogawa

¹Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan

,

Masafumi Mizuide

¹Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan

,

Yumi Mashimo

¹Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan

,

Tomonori Kawasaki

²Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan

,

Masami Yasuda

²Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan

› Author Affiliations

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.

Full Text

References

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