Outcomes of endoscopic resection for superficial duodenal epithelial neoplasia

Naohisa Yahagi, Motohiko Kato, Yasutoshi Ochiai, Tadateru Maehata, Motoki Sasaki, Yoshiyuki Kiguchi, Teppei Akimoto, Atsushi Nakayama, Ai Fujimoto, Osamu Goto, Toshio Uraoka

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background and Aims: Pancreaticoduodenectomy is an invasive procedure, and endoscopic resection (ER) is an alternative therapy. However, details regarding the outcomes of ER are unknown, especially for superficial duodenal epithelial neoplasia (SDET). The aim of this study was to elucidate the outcomes of ER for SDET and to compare EMR with endoscopic submucosal dissection (ESD). Methods: This was a retrospective observational study. From June 2010 to June 2017, 320 cases of endoscopically resected SDET (146 EMR-treated cases and 174 ESD-treated cases) were included in this study. We analyzed the proportions of en bloc resection, R0 resection, perforation, and bleeding as outcomes of ER and compared outcomes between the EMR and ESD groups. Next, we collected data on the features and clinical course of cases with adverse events. Results: The proportions of en bloc resection and R0 resection among all cases were 96.6% and 83.4%, respectively. In over 95% of cases, ESD achieved en bloc resection, regardless of lesion size. The incidences of perforation and bleeding were 8.8% and 3.4%, respectively, and the former was largely successfully managed by conservative treatment. The mortality rate was 0%, and all patients were discharged with a median hospital stay of 8.5 days (range, 4–52 days). Evaluation of the hospital stay duration according to lesion circumference revealed a significantly longer duration for lesions present on the medial wall than for other lesions (median 41 vs 7 days, P =.0331). Conclusion: The present study revealed that ER achieved secure en bloc resection, with the treatment type (ESD or EMR) selected according to the lesion size. A lesion located on the medial wall was associated with worse outcomes, such as prolonged hospital stay after perforation.

Original languageEnglish
JournalGastrointestinal Endoscopy
DOIs
Publication statusAccepted/In press - 2018 Jan 1

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Length of Stay
Neoplasms
Hemorrhage
Pancreaticoduodenectomy
Complementary Therapies
Observational Studies
Retrospective Studies
Endoscopic Mucosal Resection
Mortality
Incidence
Therapeutics
Conservative Treatment

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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Outcomes of endoscopic resection for superficial duodenal epithelial neoplasia. / Yahagi, Naohisa; Kato, Motohiko; Ochiai, Yasutoshi; Maehata, Tadateru; Sasaki, Motoki; Kiguchi, Yoshiyuki; Akimoto, Teppei; Nakayama, Atsushi; Fujimoto, Ai; Goto, Osamu; Uraoka, Toshio.

In: Gastrointestinal Endoscopy, 01.01.2018.

Research output: Contribution to journalArticle

Yahagi, N, Kato, M, Ochiai, Y, Maehata, T, Sasaki, M, Kiguchi, Y, Akimoto, T, Nakayama, A, Fujimoto, A, Goto, O & Uraoka, T 2018, 'Outcomes of endoscopic resection for superficial duodenal epithelial neoplasia', Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2018.05.002
Yahagi, Naohisa ; Kato, Motohiko ; Ochiai, Yasutoshi ; Maehata, Tadateru ; Sasaki, Motoki ; Kiguchi, Yoshiyuki ; Akimoto, Teppei ; Nakayama, Atsushi ; Fujimoto, Ai ; Goto, Osamu ; Uraoka, Toshio. / Outcomes of endoscopic resection for superficial duodenal epithelial neoplasia. In: Gastrointestinal Endoscopy. 2018.
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AU - Kato, Motohiko

AU - Ochiai, Yasutoshi

AU - Maehata, Tadateru

AU - Sasaki, Motoki

AU - Kiguchi, Yoshiyuki

AU - Akimoto, Teppei

AU - Nakayama, Atsushi

AU - Fujimoto, Ai

AU - Goto, Osamu

AU - Uraoka, Toshio

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