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CC BY-NC-ND 4.0 · Endoscopy 2023; 55(03): 261-266
DOI: 10.1055/a-1924-4711
Innovations and brief communications

A feasibility study comparing gel immersion endoscopic resection and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors

Akihiro Miyakawa 
1   Department of Gastroenterology, Asahi General Hospital, Chiba, Japan
,
Toshio Kuwai 
2   Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
,
Yukie Sakuma
3   Clinical Research Center, Asahi General Hospital, Chiba, Japan
,
Manabu Kubota
1   Department of Gastroenterology, Asahi General Hospital, Chiba, Japan
,
Akira Nakamura
1   Department of Gastroenterology, Asahi General Hospital, Chiba, Japan
,
Ei Itobayashi
1   Department of Gastroenterology, Asahi General Hospital, Chiba, Japan
,
Haruhisa Shimura
1   Department of Gastroenterology, Asahi General Hospital, Chiba, Japan
,
Yoshio Suzuki
4   Department of Pathology, Asahi General Hospital, Chiba, Japan
,
Kenji Shimura
1   Department of Gastroenterology, Asahi General Hospital, Chiba, Japan
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Abstract

Background Although gel immersion endoscopic resection (GIER) is a potential alternative to underwater endoscopic mucosal resection (UEMR) for superficial nonampullary duodenal epithelial tumors (SNADETs), comparisons between the two are currently insufficient.

Methods 40 consecutive procedures performed in 35 patients were retrospectively reviewed; the primary outcome was procedure time, and the secondary outcomes were en bloc and R0 resection rates, tumor and specimen size, and adverse events.

Results Lesions were divided into GIER (n = 22) and UEMR groups (n = 18). The median (range) procedure time was significantly shorter in the GIER group than in the UEMR group (2.75 [1–3.5] minutes vs. 3 [2] [3] [4] [5] [6] [7] [8] [9] [10] minutes; P = 0.01). The en bloc resection rate was 100 % in the GIER group, but only 83.3 % in the UEMR group. The R0 resection rate was significantly higher in the GIER group than in the UEMR group (95.5 % vs. 66.7 %; P = 0.03). The median specimen size was larger in the GIER group than in the UEMR group (14 mm vs. 7.5 mm; P < 0.001). The tumor size was not significantly different between the groups and no adverse events were observed.

Conclusions GIER is efficacious and safe to treat SNADETs, although additional studies are needed.



Publication History

Received: 19 January 2022

Accepted after revision: 11 August 2022

Accepted Manuscript online:
15 August 2022

Article published online:
10 October 2022

© 2022. 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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