Department of Gastroenterology, M. D. Anderson Cancer Center, Houston, Texas, USA.
Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, Texas, USA.
Expert Rev Gastroenterol Hepatol. 2022 Jun;16(6):569-576. doi: 10.1080/17474124.2022.2088508. Epub 2022 Jun 16.
Endoscopic mucosal resection of duodenal polyps (EMR) is a challenging intervention. The aim of this study was to review the patient characteristics, techniques, procedure outcomes, adverse events, and recurrence of duodenal polyps.
Patients were included if they had pathologically confirmed non-ampullary duodenal polyps and had received EMR with at least one follow-up EGD for surveillance. Descriptive statistics were employed to report the findings.
A total of 65 patients underwent a total of 90 EMRs for duodenal polyps. The mean age was 65.4 years, and 29 of the patients were female. Complete resection of the visible mass was achieved in 96.9% of cases. Endoscopic hemostasis was required in 18.5% of patients. Delayed bleeding occurred in 9%, and delayed perforations requiring surgical intervention occurred in 2.2% of patients with no mortality. Surgery after EMR was needed in 12.7% of cases. Eleven (16.9%) patients had recurrent duodenal adenoma on follow-up EGD.
Duodenal polyps can be safely resected and have a notable recurrence rate. This is particularly true for adenomas, warranting post-resection endoscopic surveillance. The appropriate interval for post-resection surveillance of duodenal adenomas should be a focus of future study.
十二指肠息肉的内镜黏膜切除术（EMR）是一项具有挑战性的介入治疗。本研究旨在回顾十二指肠息肉患者的特征、技术、手术结果、不良事件和复发情况。
纳入标准为经病理证实为非壶腹十二指肠息肉且接受 EMR 治疗并至少有一次随访内镜检查以进行监测的患者。采用描述性统计方法报告研究结果。
共有 65 例患者共行 90 例 EMR 治疗十二指肠息肉。患者的平均年龄为 65.4 岁，29 例为女性。96.9%的病例实现了可见肿块的完全切除。18.5%的患者需要内镜止血。9%的患者发生延迟性出血，2.2%的患者发生需要手术干预的延迟性穿孔，但无死亡病例。12.7%的患者在 EMR 后需要手术。11 例（16.9%）患者在随访内镜检查中发现复发性十二指肠腺瘤。
十二指肠息肉可以安全切除，且复发率较高。这在腺瘤中尤为明显，需要在切除后进行内镜监测。十二指肠腺瘤切除后内镜监测的适当间隔时间应是未来研究的重点。
