BACKGROUND: EMR is a viable alternative to surgery for removal of large mucosal neoplastic lesions of the entire GI tract. Few studies have, however, been published on the safety, efficacy, and technical aspects of EMR in the duodenum. OBJECTIVE: Our purpose was to evaluate the efficacy and safety of EMR of large (>15 mm) duodenal adenomas. DESIGN: Retrospective evaluation of a defined patient cohort. SETTING: Tertiary academic referral center. PATIENTS: Patients with large (>15 mm) sporadic nonampullary duodenal adenomas managed by a standardized technique who were referred by other specialist endoscopists for endoscopic treatment. METHODS: Five-year data from patients undergoing EMR for large duodenal adenomas were reviewed retrospectively. Immediate and delayed complications were recorded. RESULTS: Twenty-one lesions were removed by EMR in 23 patients (mean age 62.2 years, 13 female, 10 male). The mean size of lesions resected was 27.6 mm (median 20 mm, range 15-60 mm). Post-EMR histologic examination revealed mucosal adenocarcinoma in 1, low-grade tubulovillous adenoma (TVA) in 16, high- or focal high-grade TVA in 3 patients, and 1 with both high-grade TVA and carcinoid. EMR was performed successfully in 18 patients during a single session. Two patients required 2 sessions and 1 required 3 sessions for complete resection. The median follow-up was 13 months (range 4-44 months). During follow-up, 5 patients had minor residual adenomas that were treated successfully with snare resection and/or argon plasma coagulation. One patient had EMR site bleeding. There were no perforations. LIMITATION: Retrospective study. CONCLUSION: EMR for large sporadic nonampullary duodenal adenomas is a safe and effective technique.
BACKGROUND: EMR is a viable alternative to surgery for removal of large mucosal neoplastic lesions of the entire GI tract. Few studies have, however, been published on the safety, efficacy, and technical aspects of EMR in the duodenum. OBJECTIVE: Our purpose was to evaluate the efficacy and safety of EMR of large (>15 mm) duodenal adenomas. DESIGN: Retrospective evaluation of a defined patient cohort. SETTING: Tertiary academic referral center. PATIENTS: Patients with large (>15 mm) sporadic nonampullary duodenal adenomas managed by a standardized technique who were referred by other specialist endoscopists for endoscopic treatment. METHODS: Five-year data from patients undergoing EMR for large duodenal adenomas were reviewed retrospectively. Immediate and delayed complications were recorded. RESULTS: Twenty-one lesions were removed by EMR in 23 patients (mean age 62.2 years, 13 female, 10 male). The mean size of lesions resected was 27.6 mm (median 20 mm, range 15-60 mm). Post-EMR histologic examination revealed mucosal adenocarcinoma in 1, low-grade tubulovillous adenoma (TVA) in 16, high- or focal high-grade TVA in 3 patients, and 1 with both high-grade TVA and carcinoid. EMR was performed successfully in 18 patients during a single session. Two patients required 2 sessions and 1 required 3 sessions for complete resection. The median follow-up was 13 months (range 4-44 months). During follow-up, 5 patients had minor residual adenomas that were treated successfully with snare resection and/or argon plasma coagulation. One patient had EMR site bleeding. There were no perforations. LIMITATION: Retrospective study. CONCLUSION: EMR for large sporadic nonampullary duodenal adenomas is a safe and effective technique.
Authors: Teegan R Lim; Venkat Mahesh; Salil Singh; Benjamin H L Tan; Mohamed Elsadig; Nerukav Radhakrishnan; Phil Conlong; Chris Babbs; Regi George Journal: World J Gastroenterol Date: 2010-11-14 Impact factor: 5.742
Authors: Raf Bisschops; Miguel Areia; Emmanuel Coron; Daniela Dobru; Bernd Kaskas; Roman Kuvaev; Oliver Pech; Krish Ragunath; Bas Weusten; Pietro Familiari; Dirk Domagk; Roland Valori; Michal F Kaminski; Cristiano Spada; Michael Bretthauer; Cathy Bennett; Carlo Senore; Mário Dinis-Ribeiro; Matthew D Rutter Journal: United European Gastroenterol J Date: 2016-08-21 Impact factor: 4.623
Authors: Michael J Bartel; Ruchir Puri; Bhaumik Brahmbhatt; Wei-Chung Chen; Daniel Kim; Carlos Roberto Simons-Linares; John A Stauffer; Mauricia A Buchanan; Steven P Bowers; Timothy A Woodward; Michael B Wallace; Massimo Raimondo; Horacio J Asbun Journal: Surg Endosc Date: 2018-02-01 Impact factor: 4.584