Published online Feb 14, 2019. doi: 10.3748/wjg.v25.i6.707
Peer-review started: October 14, 2018
First decision: November 7, 2018
Revised: December 31, 2018
Accepted: January 9, 2019
Article in press: January 9, 2019
Published online: February 14, 2019
Endoscopic resection (ER) for superficial non-ampullary duodenal epithelial tumor (SNADET) is a challenging technique, due to the anatomical peculiarity of the procedure and the high frequency of the adverse event. Moreover, there are few reports on the treatment outcome of ER in many cases because of its relative rarity.
We aimed to determine the standardized criteria for endoscopic management of SNADNETs.
Based on the research background, we analyzed the results of the short-term and long-term treatment of over 100 cases of SNADET and investigated the effectiveness of ER in these cases.
This study analyzed the short- and long-term outcomes of ER. Short-term outcomes of ER included en bloc and R0 resection rates, as well as the adverse events. Long-term outcomes included local recurrence detected on endoscopic surveillance and disease-specific mortality in patients followed up for ≥ 12 mo after ER. This retrospective study included a case series of 131 patients (147 SNADETs) who underwent endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) between March 2004 and July 2017.
Over a median follow-up of 43 mo, recurrence was found in four lesions and those were treated endoscopically. No adverse events were observed in EMR-treated patients, whereas ESD for SNADETs carries a risk of bleeding and perforation. No patient died due to tumor recurrence.
Our findings suggest that ER provides good long-term outcomes in patients with SNADETs. EMR was not associated with any adverse events and, therefore, could be considered as a standard treatment for small SNADETs.
For small SNADETs, EMR is likely to become the standard treatment strategy.