Sporadic Nonampullary Duodenal Adenoma in the Natural History of Duodenal Cancer: A Study of Follow-up Surveillance

Okada, Kazuhisa; Fujisaki, Junko; Kasuga, Akiyoshi; Omae, Masami; Kubota, Manabu; Hirasawa, Toshiaki; Ishiyama, Akiyoshi; Inamori, Masahiko; Chino, Akiko; Yamamoto, Yorimasa; Tsuchida, Takaaki; Nakajima, Atsushi; Hoshino, Etsuo; Igarashi, Masahiro

doi:10.1038/ajg.2010.422

Cited by 136 publications

(142 citation statements)

References 22 publications

Supporting

Mentioning

122

Contrasting

Unclassified

Order By: Relevance

“…Recently, according to the widespread use of endoscopy, a gradual increase in the detection of SNADETs was reported. SNADETs are considered to be precancerous [2, 3], so early treatment is required. Endoscopic resection (ER), which is less invasive than surgery, is becoming a first choice treatment for SNADETs because most of the lesions are confined to the mucosa without lymph node metastasis [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Current Status of Endoscopic Resection for Superficial Nonampullary Duodenal Epithelial Tumors

et al. 2018

View full text Add to dashboard Cite

Background: Endoscopic resection (ER) is becoming the first choice of treatment for treating superficial nonampullary duodenal epithelial tumors (SNADETs), but ER procedures for SNADETs remain challenging because of the difficulty experienced in maneuvering the endoscope toward the thin duodenal wall, which results in a high rate of adverse events. Although several ER methods were used to overcome these technical difficulties and complications, ER methods for SNADETs are not standardized. A new technique, underwater endoscopic mucosal resection (UEMR), was developed recently in a western country, and its usefulness was reported. Beginning in 2014, we were the first to use UEMR for SNADETs in Japan. Thus, in our experience, we would propose an indication of the various ER methods for SNADETs according to the lesion size. Summary: Endoscopic mucosal resection (EMR) and UEMR were effective and safe for small lesions (≤20 mm), but for large lesions (>20 mm), piecemeal removal of lesion by EMR and UEMR had high incidence of recurrence and adverse events. Especially, piecemeal EMR could cause delayed perforation. Cold snare polypectomy was useful for small lesions (≤10 mm), but further study of its recurrence is warranted. Endoscopic submucosal dissection (ESD) achieved a high complete resection rate regardless of the lesion size, but its rate of adverse events, including morbid complications, was high. Thus, after ESD for large lesions, secure prevention method for adverse events, such as closure of the wound by laparoscopic-endoscopic cooperative surgery, should be required. Key Messages: ER methods for treating SNADETs were proposed based on the lesion size. For large lesions, prophylactic methods for adverse events should be implemented.

show abstract

Section: Introductionmentioning

confidence: 99%

Current Status of Endoscopic Resection for Superficial Nonampullary Duodenal Epithelial Tumors

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The potential progression of DA to carcinoma is in a sequence similar to colonic adenomas [11,46]. The evolution from DA with low-grade dysplasia to adenocarcinoma can last up to 20 years [46,47].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…The evolution from DA with low-grade dysplasia to adenocarcinoma can last up to 20 years [46,47]. Meanwhile, larger lesions than 2 cm and with a high degree of dysplasia can indicate more invasive disease.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Assessment of Duodenal Adenomas and Strategies for Curative Therapy

Pavlovic-Markovic

Dragašević²,

Krstić

et al. 2019

Dig Dis

View full text Add to dashboard Cite

Background: The increasing incidence of duodenal neoplasm has underlined different methods of resection depending on the clinical presentation, endoscopic features and histopathology. In this comprehensive review, we systematically describe the current knowledge concerning the diagnosis and management of duodenal adenomas (DAs) and discuss data considering all possible therapeutic approaches. Summary: Among a variety of duodenal lesions, including neuroendocrine tumors and gastrointestinal stromal tumors, DAs present precancerous lesions of the duodenal papilla or non-ampullary region necessitating removal. DAs can occur sporadically (SDA) as rare lesions or relatively common in polyposis syndromes. The endoscopic resections of DA are associated with an increased degree of complexity due to distinctive anatomical properties of the duodenal wall, luminal diameter and the presence of ampulla with pancreatic and biliary drainage. The endoscopic techniques including cold snare polypectomy (CSP), endoscopic mucosal resection (EMR), and argon plasma coagulation ablation are suggested to be less invasive than surgical treatment, associated with shorter hospital stay and lower cost. According to the current clinical practice, surgery has been accepted as standard therapeutic approach in familial adenomatous polyposis patients with severe polyposis or DA not amenable to endoscopic resection. Key Messages: The strategy for endoscopic resection of DAs depends on the lesion size, morphology, location, and histopathology findings. Small adenomas are most frequently diagnosed and removed by standard CSP techniques, while large laterally spreading lesions and ampullary adenoma are referred for EMR or endoscopic papillectomy respectively. Screening colonoscopy is indicated in patients with SDA. Additional studies for new endoscopic strategies and techniques for curative therapy of DAs are needed to refine future management decisions. Complete resection of DA is considered curative, but nevertheless, long-term endoscopic follow-up is still required to detect and treat any recurrent arising lesions.

show abstract

“…3 This term is used when it arises in patients without polyposis syndrome. The mean age at diagnosis is usually in the seventh decade, and the incidence is about equal between men and women.…”

Section: Discussionmentioning

confidence: 99%

Sporadic Non-ampullary Duodenal Adenoma Overriding the Cystic Dilatation of Brunner's Gland Hyperplasia

Nam

Kim

et al. 2017

Korean J Gastroenterol

View full text Add to dashboard Cite

Sporadic non-ampullary duodenal adenoma is uncommon and found incidentally during endoscopic examinations. Brunner's gland hyperplasia is commonly encountered during endoscopic examinations. Adenomas arising from Brunner's gland hyperplasia originate from the glandular cells, and the surface epithelia are usually intact. Little has been reported on adenomas originating from the surface epithelium that overrides Brunner's gland hyperplasia. Here, we report a case of a sporadic non-ampullary duodenal adenoma overriding the cystic dilatation of Brunner's gland hyperplasia. (Korean J Gastroenterol 2017;70:141-144)

show abstract

Sporadic Nonampullary Duodenal Adenoma in the Natural History of Duodenal Cancer: A Study of Follow-up Surveillance

Cited by 136 publications

References 22 publications

Current Status of Endoscopic Resection for Superficial Nonampullary Duodenal Epithelial Tumors

Current Status of Endoscopic Resection for Superficial Nonampullary Duodenal Epithelial Tumors

Assessment of Duodenal Adenomas and Strategies for Curative Therapy

Sporadic Non-ampullary Duodenal Adenoma Overriding the Cystic Dilatation of Brunner's Gland Hyperplasia

Contact Info

Product

Resources

About