TY - JOUR
T1 - Endoscopic mucosal resection of non-ampullary sporadic duodenal adenomas
T2 - a retrospective analysis with long-term follow-up
AU - Valerii, Giorgio
AU - Tringali, Andrea
AU - Landi, Rosario
AU - Boškoski, Ivo
AU - Familiari, Pietro
AU - Bizzotto, Alessandra
AU - Perri, Vincenzo
AU - Petruzziello, Lucio
AU - Costamagna, Guido
PY - 2018/4/3
Y1 - 2018/4/3
N2 - Objective: We investigate the efficiency of endoscopic mucosal resection (EMR) of non-ampullary sporadic duodenal adenomas (NASDA) in a retrospective analysis with long-term follow-up. Methods: Consecutive patients undergoing EMR of NASDA between May 2002 and December 2016 were retrospectively identified from an electronic database. Endoscopic follow-up was scheduled after 3, 6 and 12 months for the first year, then yearly for up to five years. Results: EMR of 75 NASDA was performed in 68 patients (56% en-bloc, 44% piecemeal). Retroperitoneal perforations occurred in 3/68 (4.4%) patients, were treated by surgical (n = 2) or percutaneous (n = 1) drainage; delayed bleeding was reported in 13/75 (17.3%) resections and was successfully managed by endoscopy (n = 12) or radiologic embolization (n = 1). There was no procedure-related mortality. Follow-up was available in 61/68 patients (89.7%) after a median time of 59 months from resection. Residual and recurrent adenoma were diagnosed in 9 (14.5%) and 6 (10.9%) cases, respectively; all but one were successfully retreated endoscopically. Conclusions: EMR for NASDA is effective with a favorable long-term outcome. Local recurrences can be retreated endoscopically. A recall system, patient’s compliance to endoscopic follow-up are mandatory to detect recurrences and their prompt treatment.
AB - Objective: We investigate the efficiency of endoscopic mucosal resection (EMR) of non-ampullary sporadic duodenal adenomas (NASDA) in a retrospective analysis with long-term follow-up. Methods: Consecutive patients undergoing EMR of NASDA between May 2002 and December 2016 were retrospectively identified from an electronic database. Endoscopic follow-up was scheduled after 3, 6 and 12 months for the first year, then yearly for up to five years. Results: EMR of 75 NASDA was performed in 68 patients (56% en-bloc, 44% piecemeal). Retroperitoneal perforations occurred in 3/68 (4.4%) patients, were treated by surgical (n = 2) or percutaneous (n = 1) drainage; delayed bleeding was reported in 13/75 (17.3%) resections and was successfully managed by endoscopy (n = 12) or radiologic embolization (n = 1). There was no procedure-related mortality. Follow-up was available in 61/68 patients (89.7%) after a median time of 59 months from resection. Residual and recurrent adenoma were diagnosed in 9 (14.5%) and 6 (10.9%) cases, respectively; all but one were successfully retreated endoscopically. Conclusions: EMR for NASDA is effective with a favorable long-term outcome. Local recurrences can be retreated endoscopically. A recall system, patient’s compliance to endoscopic follow-up are mandatory to detect recurrences and their prompt treatment.
KW - Colorectal cancer
KW - endoscopic mucosal resection
KW - endoscopic submucosal dissection
KW - small bowel lesions
KW - sporadic non-ampullary duodenal adenoma
UR - http://www.scopus.com/inward/record.url?scp=85042236984&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042236984&partnerID=8YFLogxK
U2 - 10.1080/00365521.2018.1438508
DO - 10.1080/00365521.2018.1438508
M3 - Article
C2 - 29458293
AN - SCOPUS:85042236984
VL - 53
SP - 490
EP - 494
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
SN - 0036-5521
IS - 4
ER -