title: Clinical outcomes of endoscopic resection for nonampullary duodenal high-grade dysplasia and intramucosal carcinoma.
abstract: This study retrospectively analyzed the clinical outcomes of endoscopic resection of 26 sporadic (i. e., not associated with polyposis syndrome) nonampullary duodenal lesions representing high-grade dysplasia or intramucosal carcinoma (duodenal HGD/IMC) in 23 patients. No severe complications such as perforation were observed, but three cases of delayed bleeding were seen. The use of endoscopic clips significantly decreased the delayed bleeding rate (0/19, 0%) compared with cases in which clips were not used (3/7, 42.9%; P = 0.013, χ2 test). Eighteen lesions (69.2%) were removed by en bloc resection. The follow-up period after resection was 25.5 ± 23.3 months. Two lesions (7.7%) that recurred locally were detected at the first surveillance endoscopy 3 months after resection. These lesions were 22 and 15 mm in size respectively and were resected piecemeal. Endoscopic resection is an effective and safe procedure for treating duodenal HGD/IMC. En bloc resection and prophylactic clip usage are encouraged.
authors: Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: D
authors: D
authors: Maruoka
authors: M
authors: M
authors: Arai
authors: T
authors: T
authors: Kishimoto
authors: T
authors: T
authors: Matsumura
authors: M
authors: M
authors: Inoue
authors: T
authors: T
authors: Nakagawa
authors: Y
authors: Y
authors: Watanabe
authors: T
authors: T
authors: Katsuno
authors: T
authors: T
authors: Tsuyuguchi
authors: F
authors: F
authors: Imazeki
authors: O
authors: O
authors: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D004379:Duodenal Neoplasms / Q000473:pathology / Q000601:surgery*; D004384:Duodenoscopy / Q000009:adverse effects; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D016558:Hemostasis, Endoscopic; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies