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Risk factors for complications and incomplete resection after endoscopic resection for duodenal submucosal tumors

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Abstract

Background and aim

Endoscopic resection (ER) has been used to remove submucosal tumors (SMTs) in recent years; however, duodenal ER is associated with high rates of immediate or delayed bleeding and perforation. Whether ER can be recommended for the treatment of duodenal SMTs remains controversial. Therefore, we aimed to investigate the clinical outcomes associated with the ER of duodenal SMTs and to assess possible predictive factors for complications and incomplete resection.

Methods

This retrospective study included 141 patients with duodenal SMTs. The therapeutic outcomes from ER and procedure-related complications were analyzed.

Results

Of the 141 patients, 78.7% achieved complete resection and nine (6.4%) developed complications. The multivariate analysis suggested that location near the duodenal papilla (P = 0.010) and diameter exceeding 15 mm (P = 0.091) of duodenal SMTs were independent risk factors for complications in ER. Besides, submucosal fibrosis (P = 0.042), location near the duodenal papilla (P = 0.049), and irregular morphology (P = 0.067) were independent risk factors for incomplete resection.

Conclusions

ER can be recommended as an effective and minimally invasive treatment for duodenal SMTs.

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (Grant No. 82170555), Shanghai Academic/Technology Research Leader (Grant No. 22XD1422400), Shuguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission (Grant No. 2022SG06), and Shanghai “Rising Stars of Medical Talent” Youth Development Program (Grant No. 20224Z0005).

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Author notes

  1. Zi-Han Geng, Yan Zhu, Yi-Fan Qu and Pei-Yao Fu shared co-first authorship.

Authors and Affiliations

  1. Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People’s Republic of China

    Zi-Han Geng, Yan Zhu, Yi-Fan Qu, Pei-Yao Fu, Wei-Feng Chen, Ping-Hong Zhou & Quan-Lin Li

  2. Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, People’s Republic of China

    Zi-Han Geng, Yan Zhu, Yi-Fan Qu, Pei-Yao Fu, Wei-Feng Chen, Ping-Hong Zhou & Quan-Lin Li

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  1. Zi-Han Geng
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  2. Yan Zhu
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Contributions

P-HZ and Q-LL created the concept and designed the project. Z-HG, YZ, Y-FQ, and P-YF drafted the manuscript. W-FC revised the manuscript. All authors contributed substantially to all aspects of the article and revised versions.

Corresponding authors

Correspondence to Ping-Hong Zhou or Quan-Lin Li.

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Disclosures

Zi-Han Geng, Yan Zhu, Yi-Fan Qu, Pei-Yao Fu, Wei-Feng Chen, Ping-Hong Zhou, and Quan-Lin Li have no conflicts of interest or financial ties to disclose.

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Geng, ZH., Zhu, Y., Qu, YF. et al. Risk factors for complications and incomplete resection after endoscopic resection for duodenal submucosal tumors. Surg Endosc 37, 9183–9189 (2023). https://doi.org/10.1007/s00464-023-10455-6

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  • DOI: https://doi.org/10.1007/s00464-023-10455-6

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