| Theme |
Advancement in Diagnosis and Treatment for Duodenal Neoplasms |
| Title |
How to Manage Nonampullary Duodenal Tumors with Endoscopic Resection |
| Author |
Ryusuke Kimura |
Department of Gastroenterology, Toranomon Hospital |
| Author |
Shu Hoteya |
Department of Gastroenterology, Toranomon Hospital |
| Author |
Daisuke Kikuchi |
Department of Gastroenterology, Toranomon Hospital |
| Author |
Mitsuru Kaise |
Department of Gastroenterology, Toranomon Hospital |
| [ Summary ] |
Superficial non-ampullary duodenal tumors (SNADT) are rare and their malignancy potential is unclear. Endoscopic resection of SNADT has been performed in a small number of cases, but an adequate management strategy for these tumors remains undefined because of their rarity and unclear clinical behavior. In our institution, we treated 59 SNADTs with ESD and 27 with EMR. The outcomes indicate high complication rates for ESDs and low en-block resection rates for EMR. In addition, immediate endoscopic closure of mucosal defects after ESD is important to prevent complications. It is more difficult to carry out endoscopic resection in the duodenum than in the other sections of the GI tract, because of the thin wall and narrow lumen of the duodenum. Therfore, experience and skill of the operator, along with adequate perioperative management, are essential. |