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Endoscopic mucosal resection vs endoscopic submucosal dissection for superficial non-ampullary duodenal tumors
- Source :
- World Journal of Gastrointestinal Oncology
- Publication Year :
- 2020
- Publisher :
- Baishideng Publishing Group Inc., 2020.
-
Abstract
- BACKGROUND The selection of endoscopic treatments for superficial non-ampullary duodenal epithelial tumors (SNADETs) is controversial. AIM To compare the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for SNADETs. METHODS We retrospectively analyzed the data of patients with SNADETs from a database of endoscopic treatment for SNADETs, which included eight hospitals in Fukuoka, Japan, between April 2001 and October 2017. A total of 142 patients with SNADETs treated with EMR or ESD were analyzed. Propensity score matching was performed to adjust for the differences in the patient characteristics between the two groups. We analyzed the treatment outcomes, including the rates of en bloc/complete resection, procedure time, adverse event rate, hospital stay, and local or metastatic recurrence. RESULTS Twenty-eight pairs of patients were created. The characteristics of patients between the two groups were similar after matching. The EMR group had a significantly shorter procedure time and hospital stay than those of the ESD group [median procedure time (interquartile range): 6 (3-10.75) min vs 87.5 (68.5-136.5) min, P < 0.001, hospital stay: 8 (6-10.75) d vs 11 (8.25-14.75) d, P = 0.006]. Other outcomes were not significantly different between the two groups (en bloc resection rate: 82.1% vs 92.9%, P = 0.42; complete resection rate: 71.4% vs 89.3%, P = 0.18; and adverse event rate: 3.6% vs 17.9%, P = 0.19, local recurrence rate: 3.6% vs 0%, P = 1; metastatic recurrence rate: 0% in both). Only one patient in the ESD group underwent emergency surgery owing to intraoperative perforation. CONCLUSION EMR has significantly shorter procedure time and hospital stay than ESD, and provides acceptable curability and safety compared to ESD. Accordingly, EMR for SNADETs is associated with lower medical costs.
- Subjects :
- medicine.medical_specialty
business.industry
Short-term
Gastroenterology
Endoscopic mucosal resection
Endoscopic submucosal dissection
Surgery
03 medical and health sciences
0302 clinical medicine
Oncology
Retrospective Study
Propensity score matching
030220 oncology & carcinogenesis
medicine
030211 gastroenterology & hepatology
business
Superficial non-ampullary duodenal epithelial tumor
Outcome
Subjects
Details
- ISSN :
- 19485204
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- World Journal of Gastrointestinal Oncology
- Accession number :
- edsair.doi.dedup.....cbe8e67518bb760d474baea3f331b0e4