Utility of underwater EMR for nonpolypoid superficial nonampullary duodenal epithelial tumors ≤20 mm

Okimoto, Kenichiro; Maruoka, Daisuke; Matsumura, Tomoaki; Kanayama, Kengo; Akizue, Naoki; Ohta, Yuki; Taida, Takashi; Saito, Keiko; Inaba, Yosuke; Kawasaki, Yohei; Arai, Makoto; Kato, Jun; Kato, Naoya

doi:10.1016/j.gie.2021.07.011

Cited by 26 publications

(30 citation statements)

References 24 publications

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“…been more reported [6][7][8][9][10][11][12][13][14][15]. UEMR is a water immersion method leading to easy snaring and low perforation risk [2,7,[11][12][13][14].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

A feasibility study comparing gel immersion endoscopic resection and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors

et al. 2022

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Background: Although gel immersion endoscopic resection (GIER) is a potential alternative to underwater endoscopic mucosal resection (UEMR) for superficial nonampullary duodenal epithelial tumor (SNADET), comparisons between the two are insufficient. Methods: Forty consecutive procedures performed in 35 patients were retrospectively reviewed; primary outcome was procedure time and secondary outcomes were en bloc and R0 resection rates, tumor and specimen size, and adverse events. Results: Lesions were divided into GIER (n = 22) and UEMR groups (n = 18). The procedure time was significantly shorter in the GIER group than that in the UEMR group (2.75 [1–3.5] min vs. 3 [2–10] min, p = 0.010). The en bloc resection rate was 100.0% in the GIER group but only 83.3% in the UEMR group. The R0 resection rate was significantly higher in the GIER group than that in the UEMR group (95.5% vs. 66.7%, p = 0.033). The specimen size was larger in the GIER group than that in the UEMR group (14 mm vs. 7.5 mm, p < 0.001). The tumor size was not significantly different between the groups and no adverse events were observed. Conclusions: GIER is efficacious and safe to treat SNADET, although additional studies are needed.

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“…been more reported [6][7][8][9][10][11][12][13][14][15]. UEMR is a water immersion method leading to easy snaring and low perforation risk [2,7,[11][12][13][14].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

A feasibility study comparing gel immersion endoscopic resection and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors

et al. 2022

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“…However, PD is an invasive treatment with a mortality rate ranging from 1 to 4% 2 , 3 . Therefore, it is very important to accurately diagnose SNADETs to allow the less invasive management such as underwater endoscopic mucosal resection 4 – 6 or endoscopic submucosal dissection 7 – 10 .…”

Section: Introductionmentioning

confidence: 99%

Magnified endoscopy with texture and color enhanced imaging with indigo carmine for superficial nonampullary duodenal tumor: a pilot study

Okimoto

Matsumura

Maruoka

et al. 2022

Sci Rep

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This pilot study aimed to investigate the utility of texture and color enhancement imaging (TXI) with magnified endoscopy (ME) for the preoperative diagnosis of superficial nonampullary duodenal epithelial tumors (SNADETs). We prospectively evaluated 12 SNADETs. The visibility for ME-TXI, ME with indigo carmine (ICME)—white-light imaging (WLI), ICME-TXI compared to ME-NBI (narrow-band imaging) was scored (+ 2 to − 2 ME-NBI was set as score 0) by 3 experts. Scores + 2 and + 1 were defined as improved visibility. The intra-observer and interobserver agreement for improved visibility of surface structure (SS) was evaluated. Sensitivity, specificity, and positive predictive value (PPV) for Vienna Classification (VCL) C4/5 associated with the preoperative diagnosis of ICME-TXI were analyzed. The SS visibility score of ICME-TXI was significantly higher than that of ME-NBI, ME-TXI, and ICME-WLI (P < 0.001 respectively). The kappa coefficients of reliability for intra-observer and interobserver agreement for the SS visibility improvement with ICME-TXI were 0.96, 1.00, 1.00 and 0.70, 0.96, 0.96 respectively. All endoscopists preferred ICME-TXI for visualizing SS mostly for all lesions. The sensitivity, specificity, and PPV (%) of ICME-TXI for VCL C4/5 were 80, 66.7, and 63.2, respectively. ICME-TXI facilitates the visibility of the SS of SNADETs and may contribute to their preoperative diagnosis.

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“…In fact, recently published retrospective studies did not find significant differences between these 2 techniques in terms of recurrence rate indicating likely similar effectiveness in improving long-term outcomes. [3][4][5][6] Whether these results can be replicated in prospective controlled studies is still unclear.…”

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confidence: 99%

The Application of Underwater Endoscopic Mucosal Resection for Nonampullary Duodenal Adenomas

Yang

2022

Clinical Gastroenterology and Hepatology

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Utility of underwater EMR for nonpolypoid superficial nonampullary duodenal epithelial tumors ≤20 mm

Cited by 26 publications

References 24 publications

A feasibility study comparing gel immersion endoscopic resection and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors

A feasibility study comparing gel immersion endoscopic resection and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors

Magnified endoscopy with texture and color enhanced imaging with indigo carmine for superficial nonampullary duodenal tumor: a pilot study

The Application of Underwater Endoscopic Mucosal Resection for Nonampullary Duodenal Adenomas

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