Published online Feb 16, 2019. doi: 10.4253/wjge.v11.i2.168
Peer-review started: November 29, 2018
First decision: January 4, 2019
Revised: January 15, 2019
Accepted: January 26, 2019
Article in press: January 26, 2019
Published online: February 16, 2019
Over-the-scope clip-assisted endoscopic full thickness resection (eFTR) of subepithelial tumors is a novel and promising endoscopic technique. Recently, there have been prospective studies investigating its use for colonic masses, but data regarding its use and efficacy in the duodenum are limited to a few reports.
A 65-year-old African American female presents for evaluation of persistent gastroesophageal reflux disease not responsive to medical treatment. A 1 cm nodule was incidentally found in the duodenum and biopsies revealed a low grade well differentiated neuroendocrine tumor. The nodule was removed using over-the-scope clip-assisted eFTR and pathology revealed clear margins. We review the available literature with a discussion on the efficacy and safety of clip-assisted eFTR s of subepithelial lesions in the duodenum.
Clip assisted eFTR appears to be a safe and efficacious treatment approach to duodenal subepithelial lesions. Further prospective studies are needed to investigate the long-term utility and safety of clip-assisted eFTR in the management of subepithelial duodenal lesions.
Core tip: Over-the-scope clip-assisted endoscopic full thickness resection (eFTR) of subepithelial tumors is a novel endoscopic technique, but has not been extensively studied in duodenal tumors. We present a case of a duodenal carcinoid tumor resected with clip-assisted eFTR that was complicated by bleeding. We explore the safety and efficacy of this procedure in light of the available literature.