| Theme | Diagnosis and Treatment of Non-ampullary Duodenal Epithelial Tumor -- Current Status and Issues | |
|---|---|---|
| Title | Duodenal Cold Snare Polypectomy (D-CSP) | |
| Publish Date | 2018/09 | |
| Author | Kohei Takizawa | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Kazuya Hosotani | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Naomi Kakushima | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Noboru Kawata | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Masao Yoshida | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Hiroyuki Ono | Division of Endoscopy, Shizuoka Cancer Center |
| [ Summary ] | Reportedly, cold snare polypectomy (CSP) minimizes the risk of complications and is used as standard treatment for the management of small colorectal polyps. We hypothesized that CSP might also be suitable to treat small duodenal polyps. CSP was performed using an electrosurgical snare without electrocautery. The polyp including the normal surrounding mucosa was snared to maintain a perilesional non-neoplastic mucosal margin. Oozing of blood immediately after CSP was observed to cease without the need for any endoscopic hemostasis. Based on the results of our study, compared with endoscopic submucosal dissection (ESD), CSP and endoscopic mucosal resection (EMR) might be safer options that can be performed rapidly for small superficial non-ampullary duodenal epithelial tumors (SNADETs). This technique appeared to be safe and offered the following advantages: 1) It did not require the use of an electrocautery; therefore, it eliminated the possibility of delayed perforation secondary to thermal burns, 2) the depth of the layer incised during CSP was shallower than that incised during ESD, and 3) the mucosal defect following CSP was smaller than that following ESD; therefore, closure is easily achievable using normal endoclips. |
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