Endoscopic mucosal resection of non-ampullary sporadic duodenal adenomas: a retrospective analysis with long-term follow-up

Giorgio Valerii, Andrea Tringali, Rosario Landi, Ivo Boškoski, Pietro Familiari, Alessandra Bizzotto, Vincenzo Perri, Lucio Petruzziello, Guido Costamagna

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)490-494
Number of pages5
JournalScandinavian Journal of Gastroenterology
Volume53
Issue number4
DOIs
Publication statusPublished - Apr 3 2018

Keywords

  • Colorectal cancer
  • endoscopic mucosal resection
  • endoscopic submucosal dissection
  • small bowel lesions
  • sporadic non-ampullary duodenal adenoma

ASJC Scopus subject areas

  • Gastroenterology

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