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Endoscopic mucosal resection using a ligation device for duodenal neuroendocrine tumors: a simple method
- Source :
- Therapeutic Advances in Gastrointestinal Endoscopy, Vol 15 (2022)
- Publication Year :
- 2022
- Publisher :
- SAGE Publishing, 2022.
-
Abstract
- Introduction: Duodenal neuroendocrine tumors (DNETs) smaller than 1 cm in diameter, without invasion to the muscularis propria, have a low risk of metastasis. Therefore, DNETs are frequently resected endoscopically. However, among the various procedures, the best fit for DNET in terms of feasibility, effectiveness, and simplicity is unclear. Methods: Patients with DNET who underwent endoscopic submucosal resection using a ligation device (ESMR-L) at Kanagawa Cancer Center between May 2003 and December 2020 were studied retrospectively to evaluate clinical characteristics and short-term and long-term outcomes. Results: Eleven consecutive patients with 12 lesions were treated with 12 sessions of ESMR-L. Lesions were discovered in patients at a median age of 68 (range, 50–83) years. One patient had two lesions at the time of the initial ESMR-L session. Eleven of the 12 lesions (91.7%) existed in the duodenal bulb, of which 10 (83.3%) were in the anterior wall, and the remaining one (8.3%) existed in the descending part of the duodenum. The en bloc and R0 resection rates were 100% and 75%, respectively. The rates of bleeding and perforation were both 0%. Among the four patients who had non-curative resections, two patients underwent additional surgery after ESMR-L. One patient had a local remnant tumor, and the other had lymph node metastasis. In cases of local remnant tumors, the vertical margin was positive in the ESMR-L specimen. In that case, ligation by the O-ring was insufficient, retrospectively. All patients had no recurrence during the median follow-up period of 5.7 years. Discussion: ESMR-L was the best fit for DNET within the indications for endoscopic resection. It is a simple procedure that enables easy and complete resection of DNETs without complications.
- Subjects :
- Diseases of the digestive system. Gastroenterology
RC799-869
Subjects
Details
- Language :
- English
- ISSN :
- 26317745
- Volume :
- 15
- Database :
- Directory of Open Access Journals
- Journal :
- Therapeutic Advances in Gastrointestinal Endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.4c4068844d84a6e8ca19503c79287d5
- Document Type :
- article
- Full Text :
- https://doi.org/10.1177/26317745221103735