Nassri Ammar B, Alkhasawneh Ahmad, Scolapio James S, Malespin Miguel H, Ribeiro Bruno de Souza
Department of Medicine, Division of Gastroenterology and Hepatology, University of Florida Health at Jacksonville, Jacksonville, FL 32209, United States.
Department of Pathology and Laboratory Medicine, University of Florida Health at Jacksonville, Jacksonville, FL 32209, United States.
World J Gastrointest Endosc. 2019 Feb 16;11(2):168-173. doi: 10.4253/wjge.v11.i2.168.
Over-the-scope clip-assisted endoscopic full thickness resection (eFTR) of subepithelial tumors is a novel and promising endoscopic technique. Recently, there have been prospective studies investigating its use for colonic masses, but data regarding its use and efficacy in the duodenum are limited to a few reports.
A 65-year-old African American female presents for evaluation of persistent gastroesophageal reflux disease not responsive to medical treatment. A 1 cm nodule was incidentally found in the duodenum and biopsies revealed a low grade well differentiated neuroendocrine tumor. The nodule was removed using over-the-scope clip-assisted eFTR and pathology revealed clear margins. We review the available literature with a discussion on the efficacy and safety of clip-assisted eFTR s of subepithelial lesions in the duodenum.
Clip assisted eFTR appears to be a safe and efficacious treatment approach to duodenal subepithelial lesions. Further prospective studies are needed to investigate the long-term utility and safety of clip-assisted eFTR in the management of subepithelial duodenal lesions.
内镜下经圈套夹辅助全层切除术(eFTR)治疗上皮下肿瘤是一种新颖且有前景的内镜技术。近期,已有前瞻性研究探讨其在结肠肿物治疗中的应用,但关于其在十二指肠应用及疗效的数据仅见于少数报道。
一名65岁非裔美国女性因持续性胃食管反流病前来评估,药物治疗无效。偶然在十二指肠发现一个1厘米的结节,活检显示为低级别高分化神经内分泌肿瘤。采用内镜下经圈套夹辅助eFTR切除该结节,病理显示切缘清晰。我们回顾现有文献,讨论圈套夹辅助eFTR治疗十二指肠上皮下病变的疗效和安全性。
圈套夹辅助eFTR似乎是治疗十二指肠上皮下病变的一种安全有效的方法。需要进一步的前瞻性研究来探讨圈套夹辅助eFTR在十二指肠上皮下病变管理中的长期效用和安全性。