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Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes

Background and study aims: The clinical benefit of endoscopic submucosal dissection (ESD) for superficial duodenal neoplasias has not yet been verified. The aims of this study were to validate the feasibility and long-term outcomes of ESD for nonampullary superficial duodenal neoplasias, larger than...

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Autores principales: Hoteya, Shu, Yahagi, Naohisa, Iizuka, Toshiro, Kikuchi, Daisuke, Mitani, Toshifumi, Matsui, Akira, Ogawa, Osamu, Yamashita, Satoshi, Furuhata, Tsukasa, Yamada, Akihiro, Kimura, Ryusuke, Nomura, Kosuke, Kuribayashi, Yasutaka, Kaise, Mitsuru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440373/
https://www.ncbi.nlm.nih.gov/pubmed/26135505
http://dx.doi.org/10.1055/s-0033-1359232
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author Hoteya, Shu
Yahagi, Naohisa
Iizuka, Toshiro
Kikuchi, Daisuke
Mitani, Toshifumi
Matsui, Akira
Ogawa, Osamu
Yamashita, Satoshi
Furuhata, Tsukasa
Yamada, Akihiro
Kimura, Ryusuke
Nomura, Kosuke
Kuribayashi, Yasutaka
Kaise, Mitsuru
author_facet Hoteya, Shu
Yahagi, Naohisa
Iizuka, Toshiro
Kikuchi, Daisuke
Mitani, Toshifumi
Matsui, Akira
Ogawa, Osamu
Yamashita, Satoshi
Furuhata, Tsukasa
Yamada, Akihiro
Kimura, Ryusuke
Nomura, Kosuke
Kuribayashi, Yasutaka
Kaise, Mitsuru
author_sort Hoteya, Shu
collection PubMed
description Background and study aims: The clinical benefit of endoscopic submucosal dissection (ESD) for superficial duodenal neoplasias has not yet been verified. The aims of this study were to validate the feasibility and long-term outcomes of ESD for nonampullary superficial duodenal neoplasias, larger than 20 mm. Patients and methods: 41 patients, with 41 nonampullary large superficial duodenal neoplasias, who underwent ESD between April 2005 to March 2013 were included in the study. The short- and long-term outcomes were retrospectively evaluated, related to tumor size, resection size, histological type, invasion depth, complete resection rate, operation time, perforation rate, delayed bleeding rate, local recurrence rate, distant metastasis, and survival rate. Results: ESD was successfully completed in 38 of 41 patients (92.7 %). The median sizes of tumors and resected specimens were, respectively, 26 mm (range 20 – 70 mm) and 36.5 mm (range 23 – 80 mm). Histopathological findings showed 13 adenocarcinomas (12 mucosal, 1 submucosal) and 28 adenomas (26 high grade dysplasia, 2 low grade dysplasia). The complete resection rate was 89.5 % (34 /38 tumors). The mean operation time was 128.3minutes. Perforation during ESD occurred in 39 % and delayed bleeding occurred in 18.4 %. The median observation period was 48 months (range 3.2 – 94.1 months), and no local recurrence or distant metastasis was seen during this time, representing a disease-free survival rate of 100 %. Conclusions: ESD for nonampullary large superficial duodenal adenocarcinoma/adenoma is feasible with favorable long-term outcomes. However, because of the high complication rate due to its technical difficulty, experience and skill of the operator, along with adequate perioperative management, are essential.
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spelling pubmed-44403732015-06-23 Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes Hoteya, Shu Yahagi, Naohisa Iizuka, Toshiro Kikuchi, Daisuke Mitani, Toshifumi Matsui, Akira Ogawa, Osamu Yamashita, Satoshi Furuhata, Tsukasa Yamada, Akihiro Kimura, Ryusuke Nomura, Kosuke Kuribayashi, Yasutaka Kaise, Mitsuru Endosc Int Open Article Background and study aims: The clinical benefit of endoscopic submucosal dissection (ESD) for superficial duodenal neoplasias has not yet been verified. The aims of this study were to validate the feasibility and long-term outcomes of ESD for nonampullary superficial duodenal neoplasias, larger than 20 mm. Patients and methods: 41 patients, with 41 nonampullary large superficial duodenal neoplasias, who underwent ESD between April 2005 to March 2013 were included in the study. The short- and long-term outcomes were retrospectively evaluated, related to tumor size, resection size, histological type, invasion depth, complete resection rate, operation time, perforation rate, delayed bleeding rate, local recurrence rate, distant metastasis, and survival rate. Results: ESD was successfully completed in 38 of 41 patients (92.7 %). The median sizes of tumors and resected specimens were, respectively, 26 mm (range 20 – 70 mm) and 36.5 mm (range 23 – 80 mm). Histopathological findings showed 13 adenocarcinomas (12 mucosal, 1 submucosal) and 28 adenomas (26 high grade dysplasia, 2 low grade dysplasia). The complete resection rate was 89.5 % (34 /38 tumors). The mean operation time was 128.3minutes. Perforation during ESD occurred in 39 % and delayed bleeding occurred in 18.4 %. The median observation period was 48 months (range 3.2 – 94.1 months), and no local recurrence or distant metastasis was seen during this time, representing a disease-free survival rate of 100 %. Conclusions: ESD for nonampullary large superficial duodenal adenocarcinoma/adenoma is feasible with favorable long-term outcomes. However, because of the high complication rate due to its technical difficulty, experience and skill of the operator, along with adequate perioperative management, are essential. © Georg Thieme Verlag KG 2013-12 /pmc/articles/PMC4440373/ /pubmed/26135505 http://dx.doi.org/10.1055/s-0033-1359232 Text en © Thieme Medical Publishers
spellingShingle Article
Hoteya, Shu
Yahagi, Naohisa
Iizuka, Toshiro
Kikuchi, Daisuke
Mitani, Toshifumi
Matsui, Akira
Ogawa, Osamu
Yamashita, Satoshi
Furuhata, Tsukasa
Yamada, Akihiro
Kimura, Ryusuke
Nomura, Kosuke
Kuribayashi, Yasutaka
Kaise, Mitsuru
Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes
title Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes
title_full Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes
title_fullStr Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes
title_full_unstemmed Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes
title_short Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes
title_sort endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440373/
https://www.ncbi.nlm.nih.gov/pubmed/26135505
http://dx.doi.org/10.1055/s-0033-1359232
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