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Endoscopic resection for duodenal carcinoid tumors: A multicenter, retrospective study
Author(s) -
Kim Gwang Ha,
Kim Jin Il,
Jeon Seong Woo,
Moon Jeong Seop,
Chung IlKwun,
Jee SamRyong,
Kim Heung Up,
Seo Geom Seog,
Baik Gwang Ho,
Lee Yong Chan
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12390
Subject(s) - medicine , endoscopic mucosal resection , perforation , carcinoid tumors , surgery , endoscopy , lymph node , endoscopic submucosal dissection , endoscopic treatment , duodenoscopy , radiology , punching , materials science , metallurgy
Background and Aim Gastrointestinal carcinoid tumors < 10 mm in diameter and limited to the submucosal layer demonstrate a low frequency of lymph node and distant metastasis, and are suitable for endoscopic treatment. The aim of this study was to assess the efficacy, safety, and long‐term prognosis of endoscopic resections for the treatment of duodenal carcinoid tumors. Methods This study included a total of 41 duodenal carcinoid tumors in 38 patients between J anuary 2006 and D ecember 2011. The indications for endoscopic resection were lesions ≤ 10 mm in diameter, confined to the submucosal layer, and without lymph node or distant metastasis. Endoscopic resection was accomplished using endoscopic mucosal resection ( EMR ), EMR with a ligation device ( EMR ‐L), EMR after circumferential precutting, or endoscopic submucosal dissection ( ESD ). Results EMR was performed in 18 tumors, EMR ‐L in 16, EMR after circumferential precutting in 3, and ESD in 4. En‐bloc resection was performed in 39 tumors (95%), and endoscopic complete resection was achieved in 40 (98%); pathological complete resection was achieved in 17 tumors (41%). The endoscopic complete resection rate did not differ according to the resection method, but the pathological complete resection rate was higher for ESD than for EMR and EMR ‐L. Intraprocedural bleeding was noted in five cases, with no occurrence of perforation. Recurrence was not observed during the mean follow‐up period of 17 months (range 1–53 months). Conclusion Endoscopic resection appears to be a safe and effective treatment for duodenal carcinoid tumors measuring ≤ 10 mm in diameter and confined to the submucosal layer.