| Theme |
Diagnosis and Treatment of Non-ampullary Duodenal Epithelial Tumor -- Current Status and Issues |
| Title |
Underwater Endoscopic Mucosal Resection |
| Author |
Shuntaro Inoue |
Department of Gastrointestinal Oncology, Osaka International Cancer Institute |
| Author |
Yasushi Yamasaki |
Gastroenterology, Okayama University Hospital |
| Author |
Noriya Uedo |
Department of Gastrointestinal Oncology, Osaka International Cancer Institute |
| [ Summary ] |
Endoscopic treatment for superficial non-papillary duodenal tumor (SNADET) is associated with a high rate of adverse events because of the anatomical features (a narrow tortuous lumen and a thin wall) of the duodenum. Several endoscopic treatment methods such as endoscopic mucosal resection (EMR), endoscopic submucosal dissection, cold snare polypectomy, and laparoscopic endoscopic cooperative surgery, among others have been reported for the treatment of SNADETs. However, to date, a standard treatment method has not been established because each method is associated with specific merits and demerits. Our hospital policy involves choosing the treatment modality based on the size of lesions. We have observed that underwater EMR is useful for the treatment of SNADETs and shows a complete resection rate of 97 %, delayed bleeding rate of 0 % and intraprocedural and delayed perforation rate of 0 %. |