Surgical Endoscopy

, Volume 33, Issue 11, pp 3605–3611 | Cite as

Endoscopic full-thickness resection (EFTR) without laparoscopic assistance for nonampullary duodenal subepithelial lesions: our clinical experience of 32 cases

  • Zhong Ren
  • Sheng-Li Lin
  • Ping-Hong ZhouEmail author
  • Shi-Lun Cai
  • Zhi-Peng Qi
  • Jian Li
  • Li-Qing Yao



Standard treatment for nonampullary duodenal tumors has not yet been established. In case of tumors originated from the muscularis propria (MP) layer and adherent to the serosa layer, the lesions can not be completely removed by ESD. However, with the development of the endoscopic suture technique, endoscopic full-thickness resection (EFTR) of duodenal subepithelial lesions has become possible.


We retrospectively analyzed 32 patients with nonampullary duodenal subepithelial lesions who underwent EFTR between February 2012 and January 2017. The suturing method, complications that occurred during and after the operations, perioperative management, tumor characteristics, and pathological findings were analyzed in all patients.


The complete resection rate was 100%; all patients successfully received EFTR except for one patient who required conversion to open surgery. Severe abdominal pain was observed after the operation in one patient who then received laparoscopic exploration, and the possibility of delayed perforation was considered. Another patient showed a decline in blood oxygen saturation (SO2) and was transferred to the intensive care unit (ICU) for further management. Delayed bleeding and fistula were not observed. All patients achieved complete remission.


EFTR is a safe, minimally invasive treatment modality that ensures complete eradication of the duodenal subepithelial lesions.


Nonampullary duodenal subepithelial lesion Endoscopic full-thickness resection Complications 


Compliance with ethical standards


Drs Zhong Ren, Sheng-Li Lin, Ping-Hong Zhou, Shi-Lun Cai, Zhi-Peng Qi, Jian Li and Li-Qing Yao have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2018_6644_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 18 KB)

Supplementary material 2 (MP4 312091 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Endoscopy Center, Endoscopy Research Institute, Zhongshan HospitalFudan UniversityShanghaiChina

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