Volume 21 Issue 5
May  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(5): 769-772
JIANG Zhen, ZHENG Yufeng, LIU Xiaomin, ZHANG Lamei. Endoscopic mucosal resection and submucosal dissection for clinical treatment of non-ampullary duodenal lesions[J]. Chinese Journal of General Practice, 2023, 21(5): 769-772. doi: 10.16766/j.cnki.issn.1674-4152.002979
Citation: JIANG Zhen, ZHENG Yufeng, LIU Xiaomin, ZHANG Lamei. Endoscopic mucosal resection and submucosal dissection for clinical treatment of non-ampullary duodenal lesions[J]. Chinese Journal of General Practice, 2023, 21(5): 769-772. doi: 10.16766/j.cnki.issn.1674-4152.002979
shu

Endoscopic mucosal resection and submucosal dissection for clinical treatment of non-ampullary duodenal lesions

doi: 10.16766/j.cnki.issn.1674-4152.002979

  • Department of Gastroenterology, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan 471000, China

Funds:

 LHGJ20200581

  • Received Date: 2022-09-18
    Abstract
  •   Objective  To analyze the safety and efficacy of endoscopic piecemeal mucosal resection (EPMR) and endoscopic submucosal dissection (ESD) in the treatment of non-ampullary duodenal lesions (NADLs).  Methods  Seventy-eight patients with NADLs who underwent surgical treatment at the Endoscopy Center, the First Affiliated Hospital of Henan University of Science and Technology from January 2013 to December 2020 were selected, and divided into EPMR group (n=24), ESD group (n=21) and EPMR+ESD group (n=33) according to surgical modality. The clinical data of the three groups were analyzed comparatively.  Results  The differences in lesion site, lesion origin, lesion size and pathological type of NADLs were not statistically significant among the three groups (all P>0.05). The duration of surgery were (59.4±4.3) min, (71.8±10.1) min and (34.4±5.8) min, respectively, with statistically significant differences (F=264.446, P < 0.05). The complete resection rates in EPMR, ESD and EPMR+ESD groups were 87.5% (21/24), 90.5% (19/21) and 100.0% (33/33), respectively, with no significant differences among the groups (χ2=4.400, P>0.05). In the EPMR group, 2 cases (8.3%) of perioperative perforation were treated endoscopically and recovered; while in the ESD group, 3 cases (14.3%) of intraoperative perforation and 2 cases (9.5%) of bleeding were treated with bipolar electrocoagulation to stop the bleeding; in the EPMR+ESD group, 1 case (3.0%) of perioperative perforation was treated with titanium clips. No infection, duodenal stenosis or other complications occurred in any of the three groups. The average postoperative hospital stay was (6.4±0.6) d, (6.4±0.8) d and (6.2±1.2) d in the three groups, respectively, with no statistically significant difference (F=0.945, P>0.05). No recurrence was observed in any of the three groups during the follow-up.  Conclusion  Both EPMR and ESD are safe and effective for NADLs, compared to a single method, their combined use for NADLs requires a shorter operative time, which will have a wide clinical application prospect.

     

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