Jang Jin Ook, Kim Tae Un, Choi Cheol Woong, Ryu Dae Gon, Park Su Bum, Lee Jung Wook, Kim Su Jin
Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Medicine (Baltimore). 2024 Nov 22;103(47):e39988. doi: 10.1097/MD.0000000000039988.
Duodenal neuroendocrine tumors are relatively rare subepithelial tumors that arise from cells of the neuroendocrine system. Small duodenal neuroendocrine tumors can be treated endoscopically because of their low potential for metastasis. This study aimed to evaluate the clinical outcomes of conventional and underwater endoscopic mucosal resection for duodenal neuroendocrine tumors. Between March 2009 and March 2023, 15 patients with duodenal neuroendocrine tumors resected using conventional (n = 7) and underwater (n = 8) endoscopic mucosal resections were retrospectively enrolled. The median specimen size and median tumor size were 1.0 cm (interquartile range: 0.8-1.2 cm) and 0.6 cm (interquartile range: 0.4-0.6 cm), respectively. More than half of duodenal neuroendocrine tumors were located in the duodenal bulb (9/15, 60%). The en bloc and complete resection rates of both conventional and underwater endoscopic mucosal resections were 100%. Only one perforation event occurred in the conventional endoscopic mucosal resection group (14.3%). The patient with the perforation was treated with endoscopic clipping. The median follow-up period was 39.5 months (interquartile range: 19.5-57.3 months). There was no local recurrence or distant metastasis during the follow-up period. Underwater endoscopic mucosal resection is a safe and effective treatment option for small duodenal neuroendocrine tumors and is the preferred treatment option for flat-type duodenal neuroendocrine tumors.
十二指肠神经内分泌肿瘤是相对罕见的起源于神经内分泌系统细胞的上皮下肿瘤。小的十二指肠神经内分泌肿瘤因其转移潜能低，可通过内镜进行治疗。本研究旨在评估传统内镜黏膜切除术和水下内镜黏膜切除术治疗十二指肠神经内分泌肿瘤的临床疗效。在2009年3月至2023年3月期间，对15例行传统内镜黏膜切除术（n = 7）和水下内镜黏膜切除术（n = 8）的十二指肠神经内分泌肿瘤患者进行了回顾性研究。标本大小中位数和肿瘤大小中位数分别为1.0 cm（四分位间距：0.8 - 1.2 cm）和0.6 cm（四分位间距：0.4 - 0.6 cm）。超过一半的十二指肠神经内分泌肿瘤位于十二指肠球部（9/15，60%）。传统内镜黏膜切除术和水下内镜黏膜切除术的整块切除率和完整切除率均为100%。传统内镜黏膜切除组仅发生1例穿孔事件（14.3%）。穿孔患者接受了内镜夹闭治疗。中位随访期为39.5个月（四分位间距：19.5 - 57.3个月）。随访期间无局部复发或远处转移。水下内镜黏膜切除术是治疗小十二指肠神经内分泌肿瘤的一种安全有效的治疗选择，也是扁平型十二指肠神经内分泌肿瘤的首选治疗方法。
