Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kameido Endoscopy and Gastroenterology Clinic, Tokyo, Japan.
J Gastroenterol Hepatol. 2022 Jan;37(1):75-80. doi: 10.1111/jgh.15666. Epub 2021 Sep 2.
The effectiveness of cold snare polypectomy (CSP) for superficial non-ampullary duodenal epithelial tumors (SNADETs) regarding long-term outcomes is not fully clarified. This study aimed to investigate long-term outcomes of CSP for SNADETs.
Patients diagnosed with sporadic SNADETs and treated with CSP at Chiba University Hospital between March 2015 and May 2018 were retrospectively analyzed. Long-term outcomes, short-term outcomes, and adverse events were investigated.
In total, 35 patients with 46 lesions were included. The en-bloc resection rate was 97.8%. Thirty-seven lesions (80.4%) were diagnosed as adenomatous. The R0 resection rate for adenomatous lesions was 70.3%. Follow-up investigations more than 12 months after CSP were completed for 35 adenomatous lesions (94.6%). The median observation period after CSP was 48 months. One patient whose observation period was only 3 months died from chronic heart failure with cardiac sarcoidosis 6 months after CSP. No patient died from SNADETs. The relapse-free survival rate at 12 months after CSP was 97.1%. One recurrence (2.7%) was observed 12 months after CSP. We removed the recurrence lesion with CSP and cold forceps polypectomy. No new recurrence occurred within the observation period. No perforation or post-operative bleeding occurred for CSP.
Cold snare polypectomy for diminutive and small SNADETs is a safe and useful procedure with a high en-bloc resection rate and long-term local control capability.
冷圈套息肉切除术（CSP）治疗非壶腹型十二指肠黏膜上皮肿瘤（SNADETs）的长期疗效尚不完全明确。本研究旨在探讨 CSP 治疗 SNADETs 的长期疗效。
回顾性分析 2015 年 3 月至 2018 年 5 月期间在千叶大学医院接受 CSP 治疗的散发性 SNADETs 患者。分析患者的长期疗效、短期疗效和不良事件。
共纳入 35 例 46 处病变患者，整块切除率为 97.8%。37 处病变（80.4%）诊断为腺瘤性，腺瘤性病变的 R0 切除率为 70.3%。35 例（94.6%）腺瘤性病变完成了 CSP 后 12 个月以上的随访。CSP 后中位观察期为 48 个月。1 例观察期仅 3 个月的患者，CSP 后 6 个月死于伴有心脏结节病的慢性心力衰竭，无患者死于 SNADETs。CSP 后 12 个月无复发生存率为 97.1%。1 例（2.7%）患者在 CSP 后 12 个月复发，我们采用 CSP 和冷活检钳息肉切除术切除了复发病变。在观察期内未发生新的复发。CSP 无穿孔或术后出血。
对于小且小的 SNADETs，冷圈套息肉切除术是一种安全有效的方法，整块切除率高，具有长期局部控制能力。
