EMR of large, sessile, sporadic nonampullary duodenal adenomas: technical aspects and long-term outcome (with videos)

Alexander, Sina; Bourke, Michael J.; Williams, Stephen J.; Bailey, Adam; Co, Jonard

doi:10.1016/j.gie.2008.04.061

Cited by 157 publications

(169 citation statements)

References 21 publications

Supporting

Mentioning

159

Contrasting

Unclassified

Order By: Relevance

“…23 Therefore, there have been only a few studies on duodenal EMR over a small number of patients. 13,[15][16][17][18][19] In the present study, the standard inject-and-cut EMR technique was used to treat the duodenal adenomas. The largest tumor resected by this method was 27 mm in diameter.…”

Section: Discussionmentioning

confidence: 99%

“…14 Since then several studies have reported endoscopic resection as a safe and effective alternative to surgery in patients with benign duodenal adenomas and for those that were poor surgical candidates. 13,[15][16][17][18][19] However, data on the adequacy of the resection and long-term outcomes are limited. This study evaluated the efficacy and long-term endos- copy findings in a cohort of Korean patients that underwent endoscopic excision of sporadic nonampullary duodenal adenomas.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and Long-Term Outcome of Endoscopic Treatment of Sporadic Nonampullary Duodenal Adenoma

Kim¹,

Chung²,

Lee³

et al. 2010

Gut Liver

View full text Add to dashboard Cite

Background/Aims: Endoscopic resection has proven to be a safe and effective alternative to surgery for duodenal adenomas. However, few data are available on the adequacy of resection and long-term outcomes. This study evaluated the efficacy and longterm endoscopic findings in a cohort of Korean patients who underwent endoscopic mucosal resection (EMR) of sporadic duodenal adenomas. Methods: Seventeen patients with nonampullary duodenal adenomas without familial polyposis syndrome and who were treated by EMR between January 2001 and December 2007 were evaluated retrospectively. Their management, follow-up, and outcomes were reviewed. Results: In total, seventeen lesions were removed from EMR in 17 patients (mean age, 59.3 years; 6 women, 11 men). The mean size of the tumors was 15.1 mm (median, 13 mm, range, 8-27 mm). Of these 17 adenomas, 16 adenomas were tubulous and 1 was tubulovillous. The EMR was performed successfully in all 17 patients in a single session. After a median follow-up period of 29 months (range, 13-72 months), all patients remained in remission. One patient had bleeding at the site of the EMR. There were no perforations after the EMR. Conclusions: EMR for sporadic duodenal adenomas seemed to be a safe and effective treatment modality. (Gut Liver 2010;4:373-377)

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and Long-Term Outcome of Endoscopic Treatment of Sporadic Nonampullary Duodenal Adenoma

Kim¹,

Chung²,

Lee³

et al. 2010

Gut Liver

View full text Add to dashboard Cite

show abstract

“…We aimed to evaluate our real-life experience and consequently infer areas of improvement. In order to reduce overtreatment with surgery and its complications, it's crucial an enhance in endoscopic pre-histological diagnosis of invasiveness, improve mucosal resection and histologic evaluation (37).…”

Section: Discussionmentioning

confidence: 99%

Oncological outcomes after endoscopic removal of malignant colorectal polyps

Gonçalves

Fontainhas

Caetano

et al. 2013

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

Objective: malignant colorectal polyp, defined by submucosally invasive adenocarcinoma, is the earliest form of clinically relevant colorectal cancer (CRC). After endoscopic resection additional surgery may be necessary, although decision criteria remain debatable. The objective of this study was to assess oncologic outcomes in terms of locoregional disease and to identify areas of improvement that may facilitate patients' management.Methods: retrospective study of 40 patients with T1 CRC endoscopically resected between 2007 and 2012. Clinicopathological features were assessed and correlated with residual disease (RD), defined as presence of adenocarcinoma in intestinal wall and/ or lymph nodes.Results: thirty-one patients underwent surgery while 9 were followed-up. After surgery, RD was confirmed in 15 (48.4 %) patients: 8 (53.3 %) wall disease, 5 (33 %) nodal metastasis, and 2 (13.3 %) with both. No recurrence was detected in the follow-up group. The characteristics of the lesions that were associated with DR were sessile configuration (p = 0.03), the degree of differentiation G3 (p = 0.01) and intercepted/indeterminate margins (p = 0.01). Twenty-two patients were operated because of inadequate evaluation, mainly due to piecemeal resection, and half of them were disease free. Postoperative complications were found in 9 (30 %) patients, mainly anastomotic leakage that was associated with rectum anterior resection (p = 0.03).Conclusions: surgery should be considered in the presence of any risk factor for residual disease, while follow-up can be offered in low risk settings. Was also demonstrated a clear need for technical improvement in endoscopic resection and pathology evaluation in order to prevent unnecessary surgeries.

show abstract

“…Endoscopic mucosal resection and endoscopic mucosal dissection of duodenal lesions is feasible [23]. However, it is complicated with higher rates of bleeding, perforation and tumor recurrence compared to EMR and ESD of colonic and stomach lesions [24].…”

Section: Combined Laparoscopic-endoscopic Approach For Duodenal Lesionsmentioning

confidence: 99%

Role of Endoscopy in Laparoscopic Procedures

Othman¹,

Patel²,

Woodward³

2011

Updated Topics in Minimally Invasive Abdominal Surgery

View full text Add to dashboard Cite

EMR of large, sessile, sporadic nonampullary duodenal adenomas: technical aspects and long-term outcome (with videos)

Cited by 157 publications

References 21 publications

Efficacy and Long-Term Outcome of Endoscopic Treatment of Sporadic Nonampullary Duodenal Adenoma

Efficacy and Long-Term Outcome of Endoscopic Treatment of Sporadic Nonampullary Duodenal Adenoma

Oncological outcomes after endoscopic removal of malignant colorectal polyps

Role of Endoscopy in Laparoscopic Procedures

Contact Info

Product

Resources

About