Granata A, Martino A, Zito FP, Ligresti D, Amata M, Lombardi G, Traina M. Exposed endoscopic full-thickness resection for duodenal submucosal tumors: Current status and future perspectives. World J Gastrointest Endosc 2022; 14(2): 77-84 [PMID: 35316982 DOI: 10.4253/wjge.v14.i2.77]
Corresponding Author of This Article
Alberto Martino, MD, Staff Physician, Department of Gastroenterology and Digestive Endoscopy, AORN “Antonio Cardarelli”, Via Antonio Cardarelli 9, Napoli 80131, Italy. alberto-martino@libero.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Feb 16, 2022; 14(2): 77-84 Published online Feb 16, 2022. doi: 10.4253/wjge.v14.i2.77
Exposed endoscopic full-thickness resection for duodenal submucosal tumors: Current status and future perspectives
Antonino Granata, Alberto Martino, Francesco Paolo Zito, Dario Ligresti, Michele Amata, Giovanni Lombardi, Mario Traina
Antonino Granata, Dario Ligresti, Michele Amata, Mario Traina, Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS–ISMETT, Palermo 90127, Italy
Alberto Martino, Francesco Paolo Zito, Giovanni Lombardi, Department of Gastroenterology and Digestive Endoscopy, AORN “Antonio Cardarelli”, Napoli 80131, Italy
Author contributions: Granata A, Martino A, Zito FP and Ligresti D designed the research and wrote, edited and finalized the text; Martino A, Ligresti D and Amata M performed literature search and analyzed the data; Lombardi G and Traina M reviewed the paper for important intellectual content.
Conflict-of-interest statement: No conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alberto Martino, MD, Staff Physician, Department of Gastroenterology and Digestive Endoscopy, AORN “Antonio Cardarelli”, Via Antonio Cardarelli 9, Napoli 80131, Italy. alberto-martino@libero.it
Received: March 20, 2021 Peer-review started: March 20, 2021 First decision: July 17, 2021 Revised: July 31, 2021 Accepted: January 13, 2022 Article in press: January 13, 2022 Published online: February 16, 2022
Abstract
Exposed endoscopic full-thickness resection (EFTR), with or without laparoscopic assistance, is an emergent natural orifice transluminal endoscopic surgery technique with promising safety and efficacy for the management of gastrointestinal submucosal tumors (SMTs) arising from the muscularis propria (MP), especially of the gastric wall. To date, evidence concerning duodenal exposed EFTR is lacking, mainly due to both the technical difficulty involved because of the special duodenal anatomy and concerns about safety and effectiveness of transmural wall defect closure. However, given the non-negligible morbidity and mortality associated with duodenal surgery, the recent availability of dedicated endoscopic tools for tissue-approximation capable to realize full-thickness defect closure could help in promoting the adoption of this endosurgical technique among referral centers. The aim of our study was to review the current evidence concerning exposed EFTR with or without laparoscopic assistance for the treatment of MP-arising duodenal SMTs.
Core Tip: Exposed endoscopic full-thickness resection (EFTR) is a promising minimally invasive alternative to surgery for the removal of gastrointestinal submucosal tumors (SMTs) originating from the muscularis propria. To date, evidence concerning duodenal exposed EFTR is lacking, mainly due to both the technical difficulty and concerns about an effective closure of the transmural defect. However, given the non-negligible morbidity and mortality associated with duodenal surgery, the recent availability of dedicated endoscopic devices able to achieve a full-thickness defect closure could help in overcoming these concerns. Our study aimed to review the current evidence regarding exposed EFTR for deep duodenal SMTs.
