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Clinical Outcomes following Endoscopic Treatment for Sporadic Nonampullary Duodenal Adenoma

Hee Kyong Na1, Do Hoon Kim2, Ji Yong Ahn2

  • 1Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea, hkna77@naver.com.

Digestive Diseases (Basel, Switzerland)
|June 10, 2020
PubMed
Abstract

Insights

Endoscopic treatment for sporadic nonampullary duodenal adenoma (SNDA) is feasible. While endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) show high resection rates, argon plasma coagulation (APC) or EMR may reduce perforation risks.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Surgical Oncology

Background:

  • Endoscopic treatment for duodenal neoplasms carries a significant risk of perforation.
  • Sporadic nonampullary duodenal adenoma (SNDA) requires evaluation for safe and effective endoscopic management.

Purpose of the Study:

  • To assess the feasibility and outcomes of endoscopic treatment for SNDA.
  • To compare the efficacy and safety of different endoscopic techniques for SNDA.

Main Methods:

  • A retrospective analysis of 92 patients with 95 SNDA lesions treated between 2005 and 2015.
  • Lesions were managed using argon plasma coagulation (APC) ablation, endoscopic mucosal resection (EMR), or endoscopic submucosal dissection (ESD).
  • Outcomes including resection rates, perforation, and recurrence were analyzed, with long-term follow-up (>12 months).

Main Results:

  • En bloc and complete resection rates were high for both EMR (83.1%, 81.4%) and ESD (90.0%, 80.0%).
  • Overall perforation occurred in 8.7% of patients; ESD had a significantly higher rate (45.5%) compared to APC (0%) and EMR (5.1%).
  • Recurrence was observed in one patient (APC group) during a median follow-up of 19 months; no recurrences were noted with EMR or ESD.

Conclusions:

  • Endoscopic treatment, particularly EMR and ESD, demonstrates favorable long-term outcomes for SNDA.
  • APC ablation or EMR may be preferable alternatives to ESD due to lower perforation risks.
  • Endoscopic management is an effective strategy for SNDA, balancing efficacy with safety considerations.
Keywords:
AdenomaArgon plasma coagulationDuodenumEndoscopic mucosal resection

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