Han Zelong, Li Qingyuan, Chua Chanelle Yeh, Wang Zhenjiang, Zhong Jun, Huang Ying, Huang Shaohui, Li Aimin, Liu Side, Luo Xiaobei
Department of Gastroenterology, Guangdong Provincial Key Laboratory of Gastroenterology, Nanfang Hospital, Southern Medical University 510515, Guangzhou, China.
Department of Internal Medicine, Medical College of Wisconsin, Milwaukee 53235, Wisconsin, USA.
Gastroenterol Res Pract. 2024 Oct 17;2024:7444677. doi: 10.1155/2024/7444677. eCollection 2024.
Endoscopic submucosal dissection (ESD) is commonly employed in the treatment of epithelial gastrointestinal tumors, but few studies have explored ESD for treatment of duodenal papillary adenomas (PAs). In this study, we aim to evaluate the feasibility of a modified ESD method as an alternative modality in the resection of PAs. We evaluated potential advantages of modified ESD for resection of sporadic duodenal PAs through retrospective analysis of 10 PAs resected via ESD compared to paired lesions undergoing endoscopic papillectomy (EP). All lesions undergoing ESD were resected en bloc with negative margins, compared to 60% of lesions undergoing EP. Within the experimental group, there was one case each of melena and pancreatitis compared to four bleeds and one case of pancreatitis in the control group. No recurrence was detected within the ESD group after a mean follow-up time of 11.2 months compared to three recurrences within a mean follow-up time of 27.7 months. From our preliminary experience, ESD is a promising alternative in the treatment of superficial duodenal PAs; however, further investigation is needed.
内镜黏膜下剥离术（ESD）常用于治疗上皮性胃肠道肿瘤，但很少有研究探讨ESD用于治疗十二指肠乳头腺瘤（PA）。在本研究中，我们旨在评估改良ESD方法作为PA切除术替代方式的可行性。我们通过回顾性分析10例经ESD切除的PA，并与接受内镜乳头切除术（EP）的配对病变进行比较，评估改良ESD切除散发性十二指肠PA的潜在优势。与60%接受EP的病变相比，所有接受ESD的病变均整块切除且切缘阴性。在实验组中，分别有1例出现黑便和胰腺炎，而在对照组中有4例出血和1例胰腺炎。ESD组平均随访11.2个月未发现复发，而对照组平均随访27.7个月有3例复发。根据我们的初步经验，ESD是治疗浅表性十二指肠PA的一种有前景的替代方法；然而，还需要进一步研究。
