Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Saudi J Gastroenterol. 2021 Sep-Oct;27(5):302-308. doi: 10.4103/sjg.sjg_646_20.
To observe and preliminarily evaluate the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in the treatment of non-ampullary duodenal lesions (NADLs).
This retrospective observational study included 84 patients who underwent endoscopic resection (ER) with non-ampullary duodenal lesions, between March 2010 and November 2020, at the Cancer Hospital of the Chinese Academy of Medical Sciences (Beijing, China). Data on patient demographics, therapeutic outcomes, and follow-up results were analyzed.
There were 44 patients undergoing EMR, and 40 patients accepting ESD. The overall en bloc resection rate was 98.8% (83/84). For the neoplastic lesions, the overall en bloc resection rate and curative rate were 98.5% (67/68) and 89.7% (61/68), respectively. The procedure-related bleeding and perforation rates were 2.4% and 10.7%, respectively. Univariate analysis results indicated that the main correlation factor of non-curative pathologic resection was tumor size (p = 0.004) and resection size (P < 0.01). There showed a higher curative rate in patients with tumors less than 25 mm in diameter. Multivariate logistic regression analyses determined that the tumor size (OR 0.935; 95% CI 0.878-0.995; P = 0.035) was associated with non-curative resection. No recurrences were observed in patients who had undergone a complete ER during a follow-up period of 42.8 months (range, 3-127 months).
Endoscopic resection is an effective, safe, and feasible treatment for non-ampullary duodenal lesions.
观察并初步评估内镜黏膜切除术（EMR）和内镜黏膜下剥离术（ESD）治疗非壶腹十二指肠病变（NADL）的疗效和安全性。
本回顾性观察研究纳入 2010 年 3 月至 2020 年 11 月在中国医学科学院肿瘤医院接受内镜下非壶腹十二指肠病变切除术的 84 例患者。分析患者的人口统计学资料、治疗结果和随访结果。
44 例行 EMR，40 例行 ESD。整块切除率为 98.8%（83/84）。对于肿瘤性病变，整块切除率和根治率分别为 98.5%（67/68）和 89.7%（61/68）。手术相关出血和穿孔的发生率分别为 2.4%和 10.7%。单因素分析结果表明，非根治性病理切除的主要相关因素是肿瘤大小（p=0.004）和切除范围（P<0.01）。肿瘤直径<25mm 的患者根治率较高。多因素 logistic 回归分析确定肿瘤大小（OR 0.935；95%CI 0.878-0.995；P=0.035）与非根治性切除相关。在接受完全内镜切除的患者中，随访 42.8 个月（范围 3-127 个月）未见复发。
内镜切除是治疗非壶腹十二指肠病变的一种有效、安全且可行的方法。
