Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Gastroenterology, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China.
Dig Endosc. 2022 Jul;34(5):1063-1068. doi: 10.1111/den.14350. Epub 2022 Jun 19.
To overcome difficulties in the removal of duodenal bulb lesions, especially those in anatomically challenging locations, we developed the endoscopic resection via antral submucosal tunneling (ERAST) technique. In this study, we evaluated the feasibility and safety of ERAST for the removal of superficial and subepithelial lesions in the duodenal bulb. This was a single-center retrospective study of 10 patients with lesions in the bulb. Submucosal tunneling from the gastric antrum to the duodenum was performed to facilitate en bloc tumor resection in the bulb. The en bloc resection rate, postoperative bleeding, and perforation were the primary endpoints. Ten lesions (four superficial and six subepithelial), with an average size of 19.1 ± 9.2 mm, were resected en bloc by ERAST. Esophagogastroduodenoscopy follow-up after 2 months indicated complete wound healing in all patients. In our primary experience, ERAST was found to be a feasible and safe endoscopic resection technique for the removal of lesions in the duodenal bulb, especially those that are difficult to access.
为了克服十二指肠球部病变，特别是那些在解剖学上具有挑战性的部位病变的切除困难，我们开发了经胃窦黏膜下隧道内镜下切除术（ERAST）技术。本研究评估了 ERAST 用于切除十二指肠球部表浅和黏膜下病变的可行性和安全性。这是一项单中心回顾性研究，纳入了 10 例球部病变患者。通过胃窦向十二指肠进行黏膜下隧道建立，以促进球部整块肿瘤切除。整块切除率、术后出血和穿孔是主要终点。10 例病变（4 例表浅，6 例黏膜下），平均大小为 19.1±9.2mm，通过 ERAST 整块切除。所有患者在术后 2 个月行食管胃十二指肠镜随访，显示完全愈合。在我们的初步经验中，ERAST 被认为是一种可行且安全的内镜切除技术，可用于切除十二指肠球部病变，特别是那些难以到达的病变。
