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Underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique: A case report
RATIONALE: Endoscopic resection of superficial non-ampullary duodenal epithelial neoplasm (SNADEN) is a challenging procedure owing to the high recurrence rate and considerable incidence rate of adverse events. PATIENT CONCERNS: SNADEN accidentally found during a medical examination in a 56-year-old...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808504/ https://www.ncbi.nlm.nih.gov/pubmed/33466153 http://dx.doi.org/10.1097/MD.0000000000024041 |
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author | Kim, Dong Hyun Park, Seon-Young Cho, Eunae Park, Chang Hwan Kim, Hyun Soo Choi, Sung Kyu Rew, Jong Sun |
author_facet | Kim, Dong Hyun Park, Seon-Young Cho, Eunae Park, Chang Hwan Kim, Hyun Soo Choi, Sung Kyu Rew, Jong Sun |
author_sort | Kim, Dong Hyun |
collection | PubMed |
description | RATIONALE: Endoscopic resection of superficial non-ampullary duodenal epithelial neoplasm (SNADEN) is a challenging procedure owing to the high recurrence rate and considerable incidence rate of adverse events. PATIENT CONCERNS: SNADEN accidentally found during a medical examination in a 56-year-old man DIAGNOSIS: The patient was diagnosed as having a 20-mm-sized flat elevated SNADEN at the superior duodenal angle. INTERVENTIONS: First, we tried to perform conventional EMR (CEMR). However, the submucosal injection interrupted the endoscopic view and did not provide enough space for CEMR because of its angulated location. Therefore, we chose to perform endoscopic resection using the “loop-and-let-go” technique. Follow-up duodenoscopy after 2 days revealed post CEMR ulcer with suspicious remnant lesion. Underwater endoscopic mucosal resection (UEMR) was successfully performed 3 months after the first session of endoscopic resection. OUTCOMES: Complete endoscopic en bloc resection and histological complete resection were achieved with UEMR. Follow-up duodenoscopy revealed no recurrence. LESSONS: Step-by-step endoscopic treatment with UEMR following loop-and-let-go technique may be a good strategy for SNADEN over 20-mm in diameter. |
format | Online Article Text |
id | pubmed-7808504 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-78085042021-01-15 Underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique: A case report Kim, Dong Hyun Park, Seon-Young Cho, Eunae Park, Chang Hwan Kim, Hyun Soo Choi, Sung Kyu Rew, Jong Sun Medicine (Baltimore) 4500 RATIONALE: Endoscopic resection of superficial non-ampullary duodenal epithelial neoplasm (SNADEN) is a challenging procedure owing to the high recurrence rate and considerable incidence rate of adverse events. PATIENT CONCERNS: SNADEN accidentally found during a medical examination in a 56-year-old man DIAGNOSIS: The patient was diagnosed as having a 20-mm-sized flat elevated SNADEN at the superior duodenal angle. INTERVENTIONS: First, we tried to perform conventional EMR (CEMR). However, the submucosal injection interrupted the endoscopic view and did not provide enough space for CEMR because of its angulated location. Therefore, we chose to perform endoscopic resection using the “loop-and-let-go” technique. Follow-up duodenoscopy after 2 days revealed post CEMR ulcer with suspicious remnant lesion. Underwater endoscopic mucosal resection (UEMR) was successfully performed 3 months after the first session of endoscopic resection. OUTCOMES: Complete endoscopic en bloc resection and histological complete resection were achieved with UEMR. Follow-up duodenoscopy revealed no recurrence. LESSONS: Step-by-step endoscopic treatment with UEMR following loop-and-let-go technique may be a good strategy for SNADEN over 20-mm in diameter. Lippincott Williams & Wilkins 2021-01-15 /pmc/articles/PMC7808504/ /pubmed/33466153 http://dx.doi.org/10.1097/MD.0000000000024041 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | 4500 Kim, Dong Hyun Park, Seon-Young Cho, Eunae Park, Chang Hwan Kim, Hyun Soo Choi, Sung Kyu Rew, Jong Sun Underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique: A case report |
title | Underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique: A case report |
title_full | Underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique: A case report |
title_fullStr | Underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique: A case report |
title_full_unstemmed | Underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique: A case report |
title_short | Underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique: A case report |
title_sort | underwater endoscopic mucosal resection of an incompletely resected superficial non-ampullary duodenal epithelial neoplasm using the loop-and-let-go technique: a case report |
topic | 4500 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808504/ https://www.ncbi.nlm.nih.gov/pubmed/33466153 http://dx.doi.org/10.1097/MD.0000000000024041 |
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