title: Laparoscopic-endoscopic cooperative surgery is a safe and effective treatment for superficial nonampullary duodenal tumors.
abstract: The use of endoscopic submucosal dissection (ESD) for duodenal neoplasms has increased in recent years, but delayed perforation and bleeding are also known to frequently occur. We present two cases in which duodenal adenoma was successfully treated with laparoscopic-endoscopic cooperative surgery. ESD was combined with laparoscopic seromuscular sutures. The lesions in both cases were located in the second portion of the duodenum. The patients requested resection of the lesion, and we performed laparoscopic-endoscopic cooperative surgery. After the laparoscopic surgeon mobilized the duodenum, the endoscopic surgeon performed ESD for the duodenal tumor without perforation. The laparoscopic surgeon sutured the duodenal wall in the seromuscular layer to strengthen the ulcer bed after ESD. Histopathological studies confirmed that the surgical margins were tumor-free in both cases. The patients were discharged with no complications. This unique laparoscopic-endoscopic cooperative procedure is a safe and effective method for resecting superficial nonampullary duodenal tumors.
authors.affiliation: Department of Surgery, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kyuno
authors.affiliation: Department of Surgery, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ohno
authors.affiliation: Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Katsuki
authors.affiliation: Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Fujita
authors.affiliation: Department of Surgery, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Konno
authors.affiliation: Department of Surgery, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Waga
authors.affiliation: Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Takanashi
authors.affiliation: Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kitaoka
authors.affiliation: Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Komatsu
authors.affiliation: Department of Surgery, Otaru Ekisaikai Hospital, Otaru, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Departments of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000368:Aged; D004379:Duodenal Neoplasms / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male
keywords: Duodenal tumor; endoscopic submucosal dissection (ESD); laparoscopic- endoscopic cooperative surgery (LECS)