Abstract
Background and study aims : Duodenal endoscopic resection (ER) is the most challenging compared to any other site in the gastrointestinal tract. The aim of this study was to analyze the clinical outcomes of duodenal ER and assess their feasibility as a therapeutic procedure.
Patients and methods : This study involved 127 patients with 134 nonampullary duodenal tumors who underwent ER included endoscopic submucosal dissections (ESD) and endoscopic mucosal resections (EMR) between January 2000 and March 2015.
Results : The median tumor size was 12mm (range, 3-50) consisting of 80 adenocarcinomas (59%) and 54 adenomas (41%) . ER performed included 125 EMRs (93%) and 9 ESDs (7%) . En-bloc resections were achieved in 87 lesions (65%) and piecemeal resection in 46 lesions (35%) except with 1 discontinuation case because of perforation. There were 11 delayed bleeding (8%) , 2 perforation (1.5%) and 1 delayed perforation (0.7%) requiring emergency surgery. Of 96 patients who were followed for more than 1 year, none of the patients died from a primary duodenal neoplasm and there were 2 local recurrences during the 38-month median follow-up period (range, 12-181) .
Conclusions : It can be acceptable to perform a piecemeal resection by EMR for small lesions based on the excellent long-term outcomes.
