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Clinical outcomes of ligation-assisted endoscopic resection for duodenal neuroendocrine tumors.

Abstract Duodenal carcinoid tumors, a type of neuroendocrine tumors, are relatively rare and are usually found incidentally during endoscopy. Small duodenal carcinoid tumors (≤10-20 mm), embedded in the submucosa, can be resected endoscopically because of the low risk of metastasis. The aim of this study was to assess the safety and efficacy of ligation-assisted endoscopic mucosal resection (EMR) for the treatment of small duodenal carcinoid tumors. The clinical outcomes of the endoscopic procedures were also evaluated.Between November 2008 and November 2017, a total of 15 duodenal carcinoid tumors embedded in the submucosa were resected using EMR. Two types of EMR (conventional EMR and ligation-assisted EMR) were performed according to tumor morphology (narrow-based and broad-based).The mean tumor size was 6.6 ± 3.9 mm and the mean procedure time was 11.0 ± 11.2 minutes. Most of the lesions (80.0%) were located in the duodenal 1st portion. Broad-based tumors were more common than narrow-based tumors (66.7% vs 33.3%). All broad-based tumors were resected successfully using ligation-assisted EMR. Although en-bloc resection and complete resection rates were higher in ligation-assisted EMR than in conventional EMR ([100% vs 87.5%], and [85.7% vs 62.5%], respectively), the difference was not significant (P = .333 and P = .310, respectively). Moreover, there was no evidence of local or distant metastasis during the follow-up (26.1 ± 20.7 months).Ligation-assisted EMR showed a higher complete resection rate than conventional EMR. Ligation-assisted EMR may be an optimal treatment option for duodenal carcinoid tumors with a broad base.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29718844
OWN - NLM
STAT- MEDLINE
DCOM- 20180514
LR  - 20180514
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 18
DP  - 2018 May
TI  - Clinical outcomes of ligation-assisted endoscopic resection for duodenal
      neuroendocrine tumors.
PG  - e0533
LID - 10.1097/MD.0000000000010533 [doi]
AB  - Duodenal carcinoid tumors, a type of neuroendocrine tumors, are relatively rare
      and are usually found incidentally during endoscopy. Small duodenal carcinoid
      tumors (</=10-20 mm), embedded in the submucosa, can be resected endoscopically
      because of the low risk of metastasis. The aim of this study was to assess the
      safety and efficacy of ligation-assisted endoscopic mucosal resection (EMR) for
      the treatment of small duodenal carcinoid tumors. The clinical outcomes of the
      endoscopic procedures were also evaluated.Between November 2008 and November
      2017, a total of 15 duodenal carcinoid tumors embedded in the submucosa were
      resected using EMR. Two types of EMR (conventional EMR and ligation-assisted EMR)
      were performed according to tumor morphology (narrow-based and broad-based).The
      mean tumor size was 6.6 +/- 3.9 mm and the mean procedure time was 11.0 +/- 11.2 
      minutes. Most of the lesions (80.0%) were located in the duodenal 1st portion.
      Broad-based tumors were more common than narrow-based tumors (66.7% vs 33.3%).
      All broad-based tumors were resected successfully using ligation-assisted EMR.
      Although en-bloc resection and complete resection rates were higher in
      ligation-assisted EMR than in conventional EMR ([100% vs 87.5%], and [85.7% vs
      62.5%], respectively), the difference was not significant (P = .333 and P = .310,
      respectively). Moreover, there was no evidence of local or distant metastasis
      during the follow-up (26.1 +/- 20.7 months).Ligation-assisted EMR showed a higher
      complete resection rate than conventional EMR. Ligation-assisted EMR may be an
      optimal treatment option for duodenal carcinoid tumors with a broad base.
FAU - Park, Su Bum
AU  - Park SB
AD  - 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.
FAU - Kang, Dae Hwan
AU  - Kang DH
FAU - Choi, Cheol Woong
AU  - Choi CW
FAU - Kim, Hyung Wook
AU  - Kim HW
FAU - Kim, Su Jin
AU  - Kim SJ
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Duodenal Neoplasms/pathology/*surgery
MH  - Duodenum/*pathology/surgery
MH  - Endoscopic Mucosal Resection/adverse effects/*methods
MH  - Female
MH  - Humans
MH  - Ligation/adverse effects/*methods
MH  - Male
MH  - Middle Aged
MH  - Neuroendocrine Tumors/*surgery
MH  - Treatment Outcome
EDAT- 2018/05/03 06:00
MHDA- 2018/05/15 06:00
CRDT- 2018/05/03 06:00
PHST- 2018/05/03 06:00 [entrez]
PHST- 2018/05/03 06:00 [pubmed]
PHST- 2018/05/15 06:00 [medline]
AID - 10.1097/MD.0000000000010533 [doi]
AID - 00005792-201805040-00012 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(18):e0533. doi: 10.1097/MD.0000000000010533.