Duodenal endoscopic full-thickness resection (with video).

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Gastrointestinal Oncology

Background:

• Duodenal adenomas and subepithelial tumors pose challenges for endoscopic resection.
• Standard endoscopic techniques carry significant risks for duodenal lesions.
• Novel endoscopic approaches are needed for safe and effective duodenal lesion removal.

Purpose of the Study:

• To evaluate the safety and efficacy of a novel over-the-scope device for duodenal endoscopic full-thickness resection (EFTR).
• To assess the technical success, R0 resection rates, and adverse events associated with this new EFTR technique.

Main Methods:

• Retrospective analysis of data from 4 consecutive patients undergoing duodenal EFTR.
• Utilized a novel over-the-scope full-thickness resection device (FTRD).
• Key outcomes included technical success, R0 resection, histologic confirmation, and adverse event monitoring.

Main Results:

• Successful resection of all duodenal lesions (2 adenomas, 2 subepithelial tumors) in 4 patients.
• Mean procedure time was 67.5 minutes; minor bleeding occurred in 2 cases without transfusion needs.
• Histology confirmed complete (R0) full-thickness resection in 3 of 4 patients, with no perforations or recurrences at 2-month follow-up.

Conclusions:

• Duodenal EFTR with the FTRD is a promising technique that may obviate the need for surgical resection.
• Device modifications are suggested to improve oral introduction.
• Further prospective studies are required to confirm the efficacy and safety of this technique for duodenal resections.