| Theme |
New Developments in Laparoscopy and Endoscopy Cooperative Surgery (LECS) |
| Title |
Endoscopy—assisted Laparoscopic Full—thickness Resection of Superficial Duodenal Neoplasms |
| Author |
Yohei Minato |
Gastroenterology, NTT Medical Center Tokyo |
| Author |
Ken Ohata |
Gastroenterology, NTT Medical Center Tokyo |
| Author |
Kouichi Nonaka |
Gastroenterology, NTT Medical Center Tokyo |
| Author |
Nobuyuki Matsuhashi |
Gastroenterology, NTT Medical Center Tokyo |
| Author |
Kimiyasu Yamazaki |
Gastroenterological and General Surgery, Showa University Hospital |
| Author |
Masahiko Murakami |
Gastroenterological and General Surgery, Showa University Hospital |
| [ Summary ] |
Superficial non‒ampullary duodenal tumors (SNADTs) are a challenging target in the digestive tract. Endoscopic resection has scarcely been utilized in the treatment of duodenal tumors because of technical difficulties and possible delayed perforation due to the action of digestive juices. On the other hand, surgical resection is an invasive method, in which determining the borderline of the lesion from outside the intestine and resecting it locally are difficult. Thus, no standard treatments of SNADT have been established. To overcome these problems, we invented a new approach for the removal of SNADTs, called "endoscopy‒assisted laparoscopic full‒thickness resection (EALFTR)", that involves a combination of endoscopic and laparoscopic techniques. Between January 2011 and March 2015, we treated 85 patients with 90 SNADTs. Successful en bloc R0 resection and full‒thickness excision were achieved with an adequate surgical margin in all of the patients without severe complications. The outcome indicates that EALFTR can be a feasible, safe, and minimally invasive treatment option for SNADTs. However, many problems remain to be solved (adaptation, peritoneal exposure, and complicated procedure). We expect more improvements in the development of duodenum laparoscopy‒endoscopy cooperative surgery. |