Lienert Andrew, Bagshaw Philip F
Christchurch Hospital, General Surgery, Christchurch, New Zealand.
ANZ J Surg. 2007 May;77(5):371-3. doi: 10.1111/j.1445-2197.2007.04063.x.
Surgical resection has been the standard treatment for duodenal adenomas. It has a high associated morbidity rate and a significant recurrence rate. The aim of this study was to evaluate endoscopic treatment of these lesions with argon plasma coagulation.
We retrospectively identified patients with non-ampullary duodenal adenomas without a polyposis syndrome and who were treated endoscopically between 1st January 1999 and 31st December 2003. Their management, follow up and outcomes were reviewed.
Fifteen patients were included, with mean age 72 years (range 46-85 years). All were treated with at least one session of argon plasma coagulation. Initially, 13 adenomas were macroscopically cleared. Of these, eight (61%) had no recurrence during mean follow up of 40 months (26-68 months). The mean time to recurrence was 14 months (6-30 months). Eradication was possible a second time in four of five recurrent adenomas. There was one complication, of haemorrhage, from 37 sessions of argon plasma coagulation. No patient developed duodenal adenocarcinoma during the study period.
Argon plasma coagulation may be safe and effective for the treatment of duodenal adenomas, but further research is required. Progression of adenomas is slow and perhaps no treatment is required.
手术切除一直是十二指肠腺瘤的标准治疗方法。其相关发病率高且复发率显著。本研究的目的是评估氩等离子体凝固术对这些病变的内镜治疗效果。
我们回顾性确定了1999年1月1日至2003年12月31日期间接受内镜治疗的无息肉病综合征的非壶腹十二指肠腺瘤患者。对他们的治疗、随访及结果进行了回顾。
纳入15例患者，平均年龄72岁（范围46 - 85岁）。所有患者均接受了至少一次氩等离子体凝固术治疗。最初，13个腺瘤在肉眼下清除。其中，8个（61%）在平均40个月（26 - 68个月）的随访期间无复发。复发的平均时间为14个月（6 - 30个月）。5个复发性腺瘤中有4个再次根除成功。在37次氩等离子体凝固术治疗中有1例出血并发症。在研究期间没有患者发生十二指肠腺癌。
氩等离子体凝固术治疗十二指肠腺瘤可能是安全有效的，但需要进一步研究。腺瘤进展缓慢，或许无需治疗。
