Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2020; 12(8): 918-930
Published online Aug 15, 2020. doi: 10.4251/wjgo.v12.i8.918
Endoscopic mucosal resection vs endoscopic submucosal dissection for superficial non-ampullary duodenal tumors
Mitsuru Esaki, Kazuhiro Haraguchi, Kazuya Akahoshi, Naru Tomoeda, Akira Aso, Soichi Itaba, Haruei Ogino, Yusuke Kitagawa, Hiroyuki Fujii, Kazuhiko Nakamura, Masaru Kubokawa, Naohiko Harada, Yosuke Minoda, Sho Suzuki, Eikichi Ihara, Yoshihiro Ogawa
Mitsuru Esaki, Haruei Ogino, Yosuke Minoda, Eikichi Ihara, Yoshihiro Ogawa, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 8128582, Japan
Mitsuru Esaki, Sho Suzuki, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo 1738610, Japan
Kazuhiro Haraguchi, Department of Gastroenterology, Hara-Sanshin Hospital, Fukuoka 8120033, Japan
Kazuya Akahoshi, Masaru Kubokawa, Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 8208502, Japan
Naru Tomoeda, Naohiko Harada, Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 8108564, Japan
Akira Aso, Department of Gastroenterology, Kitakyushu Municipal Medical Center, Kitakyushu 8020077, Japan
Soichi Itaba, Department of Gastroenterology, Kyushu Rosai Hospital, Kitakyushu 8000296, Japan
Yusuke Kitagawa, Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Fukuoka 8100001, Japan
Hiroyuki Fujii, Kazuhiko Nakamura, Department of Gastroenterology and Hepatology, National Hospital Organization Fukuokahigashi Medical Center, Koga 81103195, Japan
Eikichi Ihara, Department of Gastroenterology and Metabolism, Graduate School of Medicine Sciences, Kyushu University, Fukuoka 8128582, Japan
Author contributions: Esaki M, Minoda Y, Ogino H, and Ihara E designed the research; Esaki M drafted and revised the article for important intellectual content; Haraguchi K, Akahoshi K, Tomoeda N, Aso A, Itaba S, Kitagawa Y, Fujii H, Nakamura K, Kubokawa M, and Harada N analyzed and interpreted the data; Suzuki S critically revised the manuscript for important intellectual content; Ogawa Y supervised the whole process; all authors have read and approved the final version to be published.
Institutional review board statement: This study was conducted according to the ethical principles of the Declaration of Helsinki, and each institution’s review board and ethical committee approved the study’s protocol.
Informed consent statement: Written informed consent for performing endoscopic resection was obtained from each patient before treatment in accordance with the protocol at each institution. Consent for using the data in this study was waived because of the retrospective nature of the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: The datasets used and/or analyzed during the current study are available from corresponding author on reasonable request.
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: Eikichi Ihara, MD, PhD, Associate Professor, Department of Gastroenterology and Metabolism, Graduate School of Medicine Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 8128582, Japan.
eikichi@intmed3.med.kyushu-u.ac.jp
Received: January 1, 2020
Peer-review started: January 1, 2020
First decision: April 18, 2020
Revised: July 3, 2020
Accepted: July 19, 2020
Article in press: July 19, 2020
Published online: August 15, 2020
Processing time: 224 Days and 8.2 Hours
ARTICLE HIGHLIGHTS
Research background
Endoscopic treatments have been used as local treatments for superficial non-ampullary duodenal epithelial tumors (SNADETs) instead of surgery.
Research motivation
It remains to be determined whether endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) is more appropriate for treating SNADETs.
Research objectives
The aim of this multi-center retrospective study was to compare the treatment outcomes of EMR and ESD for SNADETs.
Research methods
Patients with SNADETs treated by EMR or ESD at eight institutions between April 2001 and October 2017. Patients were categorized into an EMR group or an ESD group. Propensity score matching analysis was conducted to compensate for confounding differences between the two groups that may affect the outcomes. After matching, the treatment outcomes were compared between the two groups.
Research results
A total of 152 patients were included and 28 pairs were matched. The EMR group had significantly shorter procedure time and hospital stay than the ESD group. The rates of en bloc resection, complete resection, and adverse events were not significantly different between the two groups.
Research conclusions
EMR provides acceptable efficacy and safety with a significantly shorter procedure time and hospital stay than ESD. Additionally, EMR for SNADETs has an advantage in total medical costs of endoscopic treatment.
Research perspectives
This was a retrospective study with a relatively small sample size and follow-up duration. Therefore, further large-scale, randomized, prospective studies are needed.
