Feasibility study comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumor < 20 mm

Background and Aim Underwater endoscopic mucosal resection (UEMR) has been reported as an alternative to conventional EMR for superficial non‐ampullary duodenal epithelial tumors (SNADET). However, the detailed outcomes are unclear. This study aimed to compare the clinical outcomes between UEMR and...

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Veröffentlicht in:Digestive endoscopy 2020-07, Vol.32 (5), p.753-760
Hauptverfasser: Kiguchi, Yoshiyuki, Kato, Motohiko, Nakayama, Atsushi, Sasaki, Motoki, Mizutani, Mari, Tsutsumi, Koushiro, Akimoto, Teppei, Takatori, Yusaku, Mutaguchi, Makoto, Takabayashi, Kaoru, Ochiai, Yasutoshi, Maehata, Tadateru, Kanai, Takanori, Yahagi, Naohisa
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container_issue 5
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container_title Digestive endoscopy
container_volume 32
creator Kiguchi, Yoshiyuki
Kato, Motohiko
Nakayama, Atsushi
Sasaki, Motoki
Mizutani, Mari
Tsutsumi, Koushiro
Akimoto, Teppei
Takatori, Yusaku
Mutaguchi, Makoto
Takabayashi, Kaoru
Ochiai, Yasutoshi
Maehata, Tadateru
Kanai, Takanori
Yahagi, Naohisa
description Background and Aim Underwater endoscopic mucosal resection (UEMR) has been reported as an alternative to conventional EMR for superficial non‐ampullary duodenal epithelial tumors (SNADET). However, the detailed outcomes are unclear. This study aimed to compare the clinical outcomes between UEMR and EMR for SNADET
doi_str_mv 10.1111/den.13524
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However, the detailed outcomes are unclear. This study aimed to compare the clinical outcomes between UEMR and EMR for SNADET &lt;20 mm. Patients and methods This is a retrospective observational study using a prospective maintained database. From November 2017 to December 2018, 104 consecutive cases of attempted UEMR for SNADET &lt;20 mm were prospectively allocated. A total of 240 cases of attempted EMR were chosen as historical controls. We compared technical success rate, defined as the resection rate without conversion to ESD; en bloc resection rate; R0 resection rate; and adverse event rate. Next, multivariate analyses were constructed to identify predictors of conversion to ESD, piecemeal resection, and RX or R1 (RX/R1) resection. Results Technical success rate of UEMR was significantly higher than that of EMR (87% and 70%, P &lt; 0.01). En bloc resection and R0 resection rates of UEMR were significantly lower than those of EMR (en bloc resection: 87% vs 96%, P &lt; 0.01; R0 resection: 67% vs 80%, P = 0.05). Concerning adverse events, there were no significant differences. In multivariate analyses, attempted EMR, lesion size and depressed type were independent predictors of conversion to ESD. Attempted UEMR was an independent predictor of piecemeal resection and RX/R1 resection. Conclusion The present study indicated that UEMR could be a feasible endoscopic resection method for SNADET (UMIN000025442).</description><identifier>ISSN: 0915-5635</identifier><identifier>EISSN: 1443-1661</identifier><identifier>DOI: 10.1111/den.13524</identifier><identifier>PMID: 31498932</identifier><language>eng</language><publisher>Australia</publisher><subject>conventional endoscopic mucosal resection ; feasibility study ; superficial non-ampullary duodenal epithelial tumor ; technical success rate ; underwater endoscopic mucosal resection</subject><ispartof>Digestive endoscopy, 2020-07, Vol.32 (5), p.753-760</ispartof><rights>2019 Japan Gastroenterological Endoscopy Society</rights><rights>2019 Japan Gastroenterological Endoscopy Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3914-303d6664900643f96dfddb3d7cfed7a21c66556e73c53e558007ebe3c3ebfdb33</citedby><cites>FETCH-LOGICAL-c3914-303d6664900643f96dfddb3d7cfed7a21c66556e73c53e558007ebe3c3ebfdb33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fden.13524$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fden.13524$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31498932$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kiguchi, Yoshiyuki</creatorcontrib><creatorcontrib>Kato, Motohiko</creatorcontrib><creatorcontrib>Nakayama, Atsushi</creatorcontrib><creatorcontrib>Sasaki, Motoki</creatorcontrib><creatorcontrib>Mizutani, Mari</creatorcontrib><creatorcontrib>Tsutsumi, Koushiro</creatorcontrib><creatorcontrib>Akimoto, Teppei</creatorcontrib><creatorcontrib>Takatori, Yusaku</creatorcontrib><creatorcontrib>Mutaguchi, Makoto</creatorcontrib><creatorcontrib>Takabayashi, Kaoru</creatorcontrib><creatorcontrib>Ochiai, Yasutoshi</creatorcontrib><creatorcontrib>Maehata, Tadateru</creatorcontrib><creatorcontrib>Kanai, Takanori</creatorcontrib><creatorcontrib>Yahagi, Naohisa</creatorcontrib><title>Feasibility study comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumor &lt; 20 mm</title><title>Digestive endoscopy</title><addtitle>Dig Endosc</addtitle><description>Background and Aim Underwater endoscopic mucosal resection (UEMR) has been reported as an alternative to conventional EMR for superficial non‐ampullary duodenal epithelial tumors (SNADET). However, the detailed outcomes are unclear. This study aimed to compare the clinical outcomes between UEMR and EMR for SNADET &lt;20 mm. Patients and methods This is a retrospective observational study using a prospective maintained database. From November 2017 to December 2018, 104 consecutive cases of attempted UEMR for SNADET &lt;20 mm were prospectively allocated. A total of 240 cases of attempted EMR were chosen as historical controls. We compared technical success rate, defined as the resection rate without conversion to ESD; en bloc resection rate; R0 resection rate; and adverse event rate. Next, multivariate analyses were constructed to identify predictors of conversion to ESD, piecemeal resection, and RX or R1 (RX/R1) resection. Results Technical success rate of UEMR was significantly higher than that of EMR (87% and 70%, P &lt; 0.01). En bloc resection and R0 resection rates of UEMR were significantly lower than those of EMR (en bloc resection: 87% vs 96%, P &lt; 0.01; R0 resection: 67% vs 80%, P = 0.05). Concerning adverse events, there were no significant differences. In multivariate analyses, attempted EMR, lesion size and depressed type were independent predictors of conversion to ESD. Attempted UEMR was an independent predictor of piecemeal resection and RX/R1 resection. Conclusion The present study indicated that UEMR could be a feasible endoscopic resection method for SNADET (UMIN000025442).</description><subject>conventional endoscopic mucosal resection</subject><subject>feasibility study</subject><subject>superficial non-ampullary duodenal epithelial tumor</subject><subject>technical success rate</subject><subject>underwater endoscopic mucosal resection</subject><issn>0915-5635</issn><issn>1443-1661</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kU1OHDEQha2IKExIFlwg8hIWDXb7Z6YlNoifEAklm2TdctvVwVHbbuw2aHYcgSNwCS7AUTgJngywg9pYpfrek58eQtuU7NEy-wb8HmWi5h_QjHLOKiol3UAz0lBRCcnEJvqc0j9CaN1w_gltMsqbRcPqGbo_BZVsZwc7LXGaslliHdyoovV_cfYG4rWaIGLwJiQdRquxyzokNeAICfRkg8fKm6LyV-BXazm9S_ch4pRHiL3Vtlx88I83t8qNeRhUXGKTQwm0chntdAHDipmyK6qDh7uaPNw59wV97NWQ4Ovzu4X-nJ78Pjqrzn99_3F0eF5p1lBeMcKMlJI3hEjO-kaa3piOmbnuwcxVTbWUQkiYMy0YCLEgZA4dMM2g6wvIttDO2neM4TJDmlpnk4byTw8hp7auF0VTU0IKurtGdQwpRejbMVpX8rSUtKuW2hKq_d9SYb892-bOgXklX2opwP4auLYDLN92ao9Pfq4tnwBh8qRI</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Kiguchi, Yoshiyuki</creator><creator>Kato, Motohiko</creator><creator>Nakayama, Atsushi</creator><creator>Sasaki, Motoki</creator><creator>Mizutani, Mari</creator><creator>Tsutsumi, Koushiro</creator><creator>Akimoto, Teppei</creator><creator>Takatori, Yusaku</creator><creator>Mutaguchi, Makoto</creator><creator>Takabayashi, Kaoru</creator><creator>Ochiai, Yasutoshi</creator><creator>Maehata, Tadateru</creator><creator>Kanai, Takanori</creator><creator>Yahagi, Naohisa</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202007</creationdate><title>Feasibility study comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumor &lt; 20 mm</title><author>Kiguchi, Yoshiyuki ; Kato, Motohiko ; Nakayama, Atsushi ; Sasaki, Motoki ; Mizutani, Mari ; Tsutsumi, Koushiro ; Akimoto, Teppei ; Takatori, Yusaku ; Mutaguchi, Makoto ; Takabayashi, Kaoru ; Ochiai, Yasutoshi ; Maehata, Tadateru ; Kanai, Takanori ; Yahagi, Naohisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3914-303d6664900643f96dfddb3d7cfed7a21c66556e73c53e558007ebe3c3ebfdb33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>conventional endoscopic mucosal resection</topic><topic>feasibility study</topic><topic>superficial non-ampullary duodenal epithelial tumor</topic><topic>technical success rate</topic><topic>underwater endoscopic mucosal resection</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kiguchi, Yoshiyuki</creatorcontrib><creatorcontrib>Kato, Motohiko</creatorcontrib><creatorcontrib>Nakayama, Atsushi</creatorcontrib><creatorcontrib>Sasaki, Motoki</creatorcontrib><creatorcontrib>Mizutani, Mari</creatorcontrib><creatorcontrib>Tsutsumi, Koushiro</creatorcontrib><creatorcontrib>Akimoto, Teppei</creatorcontrib><creatorcontrib>Takatori, Yusaku</creatorcontrib><creatorcontrib>Mutaguchi, Makoto</creatorcontrib><creatorcontrib>Takabayashi, Kaoru</creatorcontrib><creatorcontrib>Ochiai, Yasutoshi</creatorcontrib><creatorcontrib>Maehata, Tadateru</creatorcontrib><creatorcontrib>Kanai, Takanori</creatorcontrib><creatorcontrib>Yahagi, Naohisa</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kiguchi, Yoshiyuki</au><au>Kato, Motohiko</au><au>Nakayama, Atsushi</au><au>Sasaki, Motoki</au><au>Mizutani, Mari</au><au>Tsutsumi, Koushiro</au><au>Akimoto, Teppei</au><au>Takatori, Yusaku</au><au>Mutaguchi, Makoto</au><au>Takabayashi, Kaoru</au><au>Ochiai, Yasutoshi</au><au>Maehata, Tadateru</au><au>Kanai, Takanori</au><au>Yahagi, Naohisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility study comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumor &lt; 20 mm</atitle><jtitle>Digestive endoscopy</jtitle><addtitle>Dig Endosc</addtitle><date>2020-07</date><risdate>2020</risdate><volume>32</volume><issue>5</issue><spage>753</spage><epage>760</epage><pages>753-760</pages><issn>0915-5635</issn><eissn>1443-1661</eissn><abstract>Background and Aim Underwater endoscopic mucosal resection (UEMR) has been reported as an alternative to conventional EMR for superficial non‐ampullary duodenal epithelial tumors (SNADET). However, the detailed outcomes are unclear. This study aimed to compare the clinical outcomes between UEMR and EMR for SNADET &lt;20 mm. Patients and methods This is a retrospective observational study using a prospective maintained database. From November 2017 to December 2018, 104 consecutive cases of attempted UEMR for SNADET &lt;20 mm were prospectively allocated. A total of 240 cases of attempted EMR were chosen as historical controls. We compared technical success rate, defined as the resection rate without conversion to ESD; en bloc resection rate; R0 resection rate; and adverse event rate. Next, multivariate analyses were constructed to identify predictors of conversion to ESD, piecemeal resection, and RX or R1 (RX/R1) resection. Results Technical success rate of UEMR was significantly higher than that of EMR (87% and 70%, P &lt; 0.01). En bloc resection and R0 resection rates of UEMR were significantly lower than those of EMR (en bloc resection: 87% vs 96%, P &lt; 0.01; R0 resection: 67% vs 80%, P = 0.05). Concerning adverse events, there were no significant differences. In multivariate analyses, attempted EMR, lesion size and depressed type were independent predictors of conversion to ESD. Attempted UEMR was an independent predictor of piecemeal resection and RX/R1 resection. Conclusion The present study indicated that UEMR could be a feasible endoscopic resection method for SNADET (UMIN000025442).</abstract><cop>Australia</cop><pmid>31498932</pmid><doi>10.1111/den.13524</doi><tpages>8</tpages></addata></record>
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source Wiley Online Library Journals Frontfile Complete
subjects conventional endoscopic mucosal resection
feasibility study
superficial non-ampullary duodenal epithelial tumor
technical success rate
underwater endoscopic mucosal resection
title Feasibility study comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumor < 20 mm
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