Underwater endoscopic mucosal resection for superficial nonampullary duodenal adenomas

Yasushi Yamasaki, Noriya Uedo, Yoji Takeuchi, Koji Higashino, Noboru Hanaoka, Tomofumi Akasaka, Minoru Kato, Kenta Hamada, Yusuke Tonai, Noriko Matsuura, Takashi Kanesaka, Masamichi Arao, Sho Suzuki, Taro Iwatsubo, Satoki Shichijo, Hiroko Nakahira, Ryu Ishihara, Hiroyasu Iishi

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

BACKGROUND AND STUDY AIM: Underwater endoscopic mucosal resection (UEMR) was recently developed in a Western country. A prospective cohort study to investigate the effectiveness of UEMR was conducted in patients with small superficial nonampullary duodenal adenomas.

PATIENTS AND METHODS: Patients with duodenal adenomas ≤ 20 mm were enrolled. After the duodenal lumen had been filled with physiological saline, UEMR was performed without submucosal injection. Endoclip closure was attempted for all mucosal defects after UEMR. Follow-up endoscopy with biopsy was performed 3 months later. The primary end point was the complete resection rate, defined as neither endoscopic nor histological residue of adenoma at the follow-up endoscopy.

RESULTS: 30 patients with 31 lesions were enrolled. The mean (SD) tumor size was 12.0 mm (7.3). The complete resection rate was 97 % (90 % confidence interval, 87 % - 99 %). The en bloc resection rate was 87 %. All mucosal defects were successfully closed by endoclips. No adverse events occurred except for one case of mild aspiration pneumonia.

CONCLUSIONS: UEMR is efficacious for the treatment of small duodenal adenomas, but further large-scale trials are warranted to confirm these results.

Original languageEnglish
Pages (from-to)154-158
Number of pages5
JournalEndoscopy
Volume50
Issue number2
DOIs
Publication statusPublished - Feb 2018
Externally publishedYes

Fingerprint

Adenoma
Endoscopy
Aspiration Pneumonia
Cohort Studies
Endoscopic Mucosal Resection
Prospective Studies
Confidence Intervals
Biopsy
Injections
Neoplasms
Therapeutics

Keywords

  • Adenoma/diagnosis
  • Biopsy
  • Duodenal Neoplasms/diagnosis
  • Duodenoscopy/methods
  • Endoscopic Mucosal Resection/methods
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Mucosa/pathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Time Factors
  • Treatment Outcome

Cite this

Yamasaki, Y., Uedo, N., Takeuchi, Y., Higashino, K., Hanaoka, N., Akasaka, T., ... Iishi, H. (2018). Underwater endoscopic mucosal resection for superficial nonampullary duodenal adenomas. Endoscopy, 50(2), 154-158. https://doi.org/10.1055/s-0043-119214

Underwater endoscopic mucosal resection for superficial nonampullary duodenal adenomas. / Yamasaki, Yasushi; Uedo, Noriya; Takeuchi, Yoji; Higashino, Koji; Hanaoka, Noboru; Akasaka, Tomofumi; Kato, Minoru; Hamada, Kenta; Tonai, Yusuke; Matsuura, Noriko; Kanesaka, Takashi; Arao, Masamichi; Suzuki, Sho; Iwatsubo, Taro; Shichijo, Satoki; Nakahira, Hiroko; Ishihara, Ryu; Iishi, Hiroyasu.

In: Endoscopy, Vol. 50, No. 2, 02.2018, p. 154-158.

Research output: Contribution to journalArticle

Yamasaki, Y, Uedo, N, Takeuchi, Y, Higashino, K, Hanaoka, N, Akasaka, T, Kato, M, Hamada, K, Tonai, Y, Matsuura, N, Kanesaka, T, Arao, M, Suzuki, S, Iwatsubo, T, Shichijo, S, Nakahira, H, Ishihara, R & Iishi, H 2018, 'Underwater endoscopic mucosal resection for superficial nonampullary duodenal adenomas', Endoscopy, vol. 50, no. 2, pp. 154-158. https://doi.org/10.1055/s-0043-119214
Yamasaki, Yasushi ; Uedo, Noriya ; Takeuchi, Yoji ; Higashino, Koji ; Hanaoka, Noboru ; Akasaka, Tomofumi ; Kato, Minoru ; Hamada, Kenta ; Tonai, Yusuke ; Matsuura, Noriko ; Kanesaka, Takashi ; Arao, Masamichi ; Suzuki, Sho ; Iwatsubo, Taro ; Shichijo, Satoki ; Nakahira, Hiroko ; Ishihara, Ryu ; Iishi, Hiroyasu. / Underwater endoscopic mucosal resection for superficial nonampullary duodenal adenomas. In: Endoscopy. 2018 ; Vol. 50, No. 2. pp. 154-158.
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T1 - Underwater endoscopic mucosal resection for superficial nonampullary duodenal adenomas

AU - Yamasaki, Yasushi

AU - Uedo, Noriya

AU - Takeuchi, Yoji

AU - Higashino, Koji

AU - Hanaoka, Noboru

AU - Akasaka, Tomofumi

AU - Kato, Minoru

AU - Hamada, Kenta

AU - Tonai, Yusuke

AU - Matsuura, Noriko

AU - Kanesaka, Takashi

AU - Arao, Masamichi

AU - Suzuki, Sho

AU - Iwatsubo, Taro

AU - Shichijo, Satoki

AU - Nakahira, Hiroko

AU - Ishihara, Ryu

AU - Iishi, Hiroyasu

N1 - © Georg Thieme Verlag KG Stuttgart · New York.

PY - 2018/2

Y1 - 2018/2

N2 - BACKGROUND AND STUDY AIM: Underwater endoscopic mucosal resection (UEMR) was recently developed in a Western country. A prospective cohort study to investigate the effectiveness of UEMR was conducted in patients with small superficial nonampullary duodenal adenomas.PATIENTS AND METHODS: Patients with duodenal adenomas ≤ 20 mm were enrolled. After the duodenal lumen had been filled with physiological saline, UEMR was performed without submucosal injection. Endoclip closure was attempted for all mucosal defects after UEMR. Follow-up endoscopy with biopsy was performed 3 months later. The primary end point was the complete resection rate, defined as neither endoscopic nor histological residue of adenoma at the follow-up endoscopy.RESULTS: 30 patients with 31 lesions were enrolled. The mean (SD) tumor size was 12.0 mm (7.3). The complete resection rate was 97 % (90 % confidence interval, 87 % - 99 %). The en bloc resection rate was 87 %. All mucosal defects were successfully closed by endoclips. No adverse events occurred except for one case of mild aspiration pneumonia.CONCLUSIONS: UEMR is efficacious for the treatment of small duodenal adenomas, but further large-scale trials are warranted to confirm these results.

AB - BACKGROUND AND STUDY AIM: Underwater endoscopic mucosal resection (UEMR) was recently developed in a Western country. A prospective cohort study to investigate the effectiveness of UEMR was conducted in patients with small superficial nonampullary duodenal adenomas.PATIENTS AND METHODS: Patients with duodenal adenomas ≤ 20 mm were enrolled. After the duodenal lumen had been filled with physiological saline, UEMR was performed without submucosal injection. Endoclip closure was attempted for all mucosal defects after UEMR. Follow-up endoscopy with biopsy was performed 3 months later. The primary end point was the complete resection rate, defined as neither endoscopic nor histological residue of adenoma at the follow-up endoscopy.RESULTS: 30 patients with 31 lesions were enrolled. The mean (SD) tumor size was 12.0 mm (7.3). The complete resection rate was 97 % (90 % confidence interval, 87 % - 99 %). The en bloc resection rate was 87 %. All mucosal defects were successfully closed by endoclips. No adverse events occurred except for one case of mild aspiration pneumonia.CONCLUSIONS: UEMR is efficacious for the treatment of small duodenal adenomas, but further large-scale trials are warranted to confirm these results.

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KW - Duodenal Neoplasms/diagnosis

KW - Duodenoscopy/methods

KW - Endoscopic Mucosal Resection/methods

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Intestinal Mucosa/pathology

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Time Factors

KW - Treatment Outcome

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DO - 10.1055/s-0043-119214

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VL - 50

SP - 154

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JO - Endoscopy

JF - Endoscopy

SN - 0013-726X

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ER -