Yoshikane H, Goto H, Niwa Y, Matsui M, Ohashi S, Suzuki T, Hamajima E, Hayakawa T
Department of Internal Medicine, Handa City Hospital, Handa, Aichi, Japan.
Gastrointest Endosc. 1998 Jun;47(6):466-70. doi: 10.1016/s0016-5107(98)70246-9.
Most cases of duodenal carcinoid have conventionally been treated by surgical resection. The aim of our study was to explore the feasibility of endoscopic resection in small duodenal carcinoids.
The study population consisted of seven patients with small duodenal carcinoids. The diagnosis was confirmed by preoperative biopsies. The depth of tumor invasion was evaluated by endosonography.
The carcinoid was detected by endosonography in all cases. Size ranged ultrasonographically from 1.5 mm to 7 mm. Tumor invasion was confined to the submucosa in all patients. Endoscopic resection was performed with the strip biopsy technique using a two-channel endoscope. In six patients, the specimens were resected without severe complications. Five of them were confirmed histologically to be typical carcinoids. In one patient, carcinoid was not detected histologically in the specimen. In the remaining patient, a perforation occurred. However, the huge ulcer was managed conservatively. Follow-up endoscopy revealed no evidence of recurrent or residual tumor in any patient.
Small duodenal carcinoids confined to the submucosa can be resected endoscopically and preoperative endosonography is necessary for the determination of endoscopic resectability.
十二指肠类癌的大多数病例传统上采用手术切除治疗。我们研究的目的是探讨内镜切除小十二指肠类癌的可行性。
研究对象包括7例小十二指肠类癌患者。术前活检确诊。通过内镜超声评估肿瘤浸润深度。
所有病例均通过内镜超声检测到类癌。超声检查大小范围为1.5毫米至7毫米。所有患者的肿瘤浸润均局限于黏膜下层。使用双通道内镜通过条带活检技术进行内镜切除。6例患者的标本切除无严重并发症。其中5例经组织学证实为典型类癌。1例患者的标本中未在组织学上检测到类癌。其余1例患者发生穿孔。然而，巨大溃疡经保守治疗。随访内镜检查显示所有患者均无复发或残留肿瘤的证据。
局限于黏膜下层的小十二指肠类癌可通过内镜切除，术前内镜超声对于确定内镜可切除性是必要的。
