Nisan 2024
Büyük yüzeyel duodenal epitelyal neoplazi tedavisinde endoskopik submukozal diseksiyonun rolü
The role of endoscopic submucosal dissection in the treatment of large superficial duodenal epithelial neoplasi
- Ana Sayfa
- Sayılar
- Nisan 2024
- Büyük yüzeyel duodenal epitelyal neoplazi tedavisinde endoskopik submukozal diseksiyonun rolü...
Department of 3Gastroentrerology, University of Health Sciences, Bilkent City Hospital, Ankara, Turkey
Özet
Giris ve Amaç: Endoskopik submukozal diseksiyon, 2 cm’den büyük yüzeyel duodenal epitelyal neoplazmi olan hastalarda en-blok rezeksiyonun kolaylastirilmasi açisindan önerilen tedavi yöntemlerinden biridir. Literatürde endoskopik submukozal diseksiyonun yüzeyel duodenal epitelyal neoplazmda uygulanabilirligi hakkinda sinirli bilgi bulunmaktadir. Bu çalismada endoskopik submukozal diseksiyon uygulanan sekiz yüzeyel duodenal epitelyal neoplasm hastasinin sonuçlari retrospektif olarak analiz edildi. Gereç ve Yöntem: Subat 2019 ile Kasim 2023 tarihleri arasinda duodenal endoskopik submukozal diseksiyon uygulanan 12 hasta tarandi. Yüzeyel duodenal epitelyal neoplazmi 2 cm’den büyük olan 8 hasta çalismaya dahil edildi. Bulgular: Medyan tümör çapi 27.5 mm (20 - 80 mm) idi. En sik lokalizasyon duodenumun ikinci kismiydi (%87.5). En blok ve R0 rezeksiyon oranlarinin her biri %100 idi. Ortalama islem süresi 37.5 dakika idi. Komplikasyon gelisen iki hasta (%20) endoskopik kliplerle tedavi edildi. Hastalarin tamaminda (ortalama 21 ay) nüks görülmedi. Sonuç: Endoskopik submukozal diseksiyon, yüzeyel duodenal epitelyal neoplazm tedavisinde teknik açidan zor ancak basarili bir yöntemdir. Komplikasyon riskinin yüksek olmasi nedeniyle duodenal endoskopik submukozal diseksiyon deneyimli merkezlerde yapilmalidir
Abstract
Background and Aims: Endoscopic submucosal dissection is one of the recommended treatment modality in terms of facilitating en-bloc resection in patients with superficial duodenal epithelial neoplasm larger than 2 cm. There is limited information in the literature about the applicability of endoscopic submucosal dissection in superficial duodenal epithelial neoplasm. In this single-center study, the results of eight patients with superficial duodenal epithelial neoplasm who underwent endoscopic submucosal dissection were retrospectively analyzed. Materials and Methods: Twelve patients who underwent duodenal endoscopic submucosal dissection between February 2019 and November 2023 were screened. Eight patients with superficial duodenal epithelial neoplasm larger than 2 cm were included in the study. Results: The median tumor diameter was 27.5 mm (20 - 80 mm). The most common localization was the duodenum second part (87.5%). En bloc and R0 resection rates were each 100%. The median procedure time was 37.5 min. Two patients (20%) with complications were treated with endoscopic clips. No recurrence was observed in all patients (mean 21 months). Conclusion: Endoscopic submucosal dissection is a technically challenging but successful method in the treatment of superficial duodenal epithelial neoplasm. Due to the high risk of complications, duodenal endoscopic submucosal dissection should be performed in experienced centers
