Abstract
Background and Aim
Endoscopic resection is recommended for small duodenal neuroendocrine tumors DNETs. However, there is limited data on the outcomes of endoscopic submucosal dissection (ESD) in DNETs. In this study, we aimed to evaluate the outcomes of ESD in DNETs.
Methods
Data of consecutive patients who underwent ESD for DNETs from January 2018 to December 2019 were analyzed, retrospectively. All the cases of ESD were performed with or without traction using rubber band and two endoclips. En-bloc resection, complete endoscopic resection (C-ER), complete pathological resection (C-PR), adverse events, and recurrence were evaluated.
Results
Twenty patients (19 males, 57.50 ± 9.32 years) underwent ESD for DNETs. DNETs measured ≤ 10 mm (7), 10–15 mm (12), and > 15 mm (1). ESD was performed with and without traction in 10 cases each. Mean operating time was 61 ± 17.38 min. En-bloc resection, C-ER, and C-PR were recorded in 90%, 95%, and 75%, respectively. Vertical margins were positive in five patients. Adverse events included perforations in 4 (20%) cases and major bleeding in one case. There was no recurrence at a mean follow-up of 17.20 ± 7.37 months.
Conclusion
ESD is feasible and effective for the management of DNETs. However, caution is advised due to a high risk of adverse events and pathologically incomplete resection.
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References
Delle Fave G, O'Toole D, Sundin A, Taal B, Ferolla P, Ramage JK, et al. ENETS Consensus Guidelines Update for Gastroduodenal Neuroendocrine Neoplasms. Neuroendocrinology. 2016;103:119-24.
Yamamoto H, Miura Y. Duodenal ESD: conquering difficulties. Gastrointest Endosc Clin N Am. 2014;24:235-44.
Standards of Practice C, Faulx AL, Kothari S, Acosta RD, Agrawal D, Bruining DH, et al. The role of endoscopy in subepithelial lesions of the GI tract. Gastrointest Endosc. 2017;85:1117-32.
Matsumoto S, Miyatani H, Yoshida Y, Nokubi M. Duodenal carcinoid tumors: 5 cases treated by endoscopic submucosal dissection. Gastrointest Endosc. 2011;74:1152-6.
Suzuki S, Ishii N, Uemura M, Deshpande GA, Matsuda M, Iizuka Y, et al. Endoscopic submucosal dissection (ESD) for gastrointestinal carcinoid tumors. Surg Endosc. 2012;26:759-63.
Parra-Blanco A, Nicolas D, Arnau MR, Gimeno-Garcia AZ, Rodrigo L, Quintero E. Gastric endoscopic submucosal dissection assisted by a new traction method: the clip-band technique. A feasibility study in a porcine model (with video). Gastrointest Endosc. 2011;74:1137-41.
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1). Zaheer Nabi, and Mohan Ramchandani were involved in the conception of the study.
2). Radhika Chavan and Jahangeer Basha were involved in the acquisition and analysis of the data.
3). Santosh Darisetty, Shujaath Asif, and D. Nageshwar Reddy were involved in revising the manuscript for important intellectual content.
All the authors agreed to the final version of the manuscript.
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Supplementary Video: Technique of ESD in duodenum using rubber band traction technique (MP4 202437 KB)
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Nabi, Z., Ramchandani, M., Asif, S. et al. Outcomes of Endoscopic Submucosal Dissection in Duodenal Neuroendocrine Tumors. J Gastrointest Surg 26, 275–277 (2022). https://doi.org/10.1007/s11605-021-05133-8
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DOI: https://doi.org/10.1007/s11605-021-05133-8