Endoscopic resection in combination with ligation for the treatment of duodenal subepithelial lesions: a single-center experience

• Published in: Revista española de enfermedades digestivas Vol. 114; no. 6; pp. 343 - 347
• Main Authors: Li, De-Feng, Shi, Rui-Yue, Xiong, Feng, Zhang, Hai-Yang, Liu, Ting-Ting, Tian, Yan-Hui, Xu, Zheng-Lei, Wu, Ben-Hua, Zhang, Ding-Guo, Yao, Jun, Wang, Li-Sheng
• Format: Journal Article
• Language: English; Spanish
• Published: Spain Sociedad Espanola de Patologia Digestivas 01.06.2022
• Subjects: Duodenal Neoplasms - pathology; Duodenal Neoplasms - surgery; Duodenum - pathology; Endoscopic Mucosal Resection - methods; Humans; Ligation; Retrospective Studies; Stomach Neoplasms; Treatment Outcome
• ISSN: 1130-0108
• DOI: 10.17235/reed.2021.8105/2021

duodenal subepithelial lesions (SELs) are increasingly detected during endoscopic examinations. However, no feasible and safe methods are available to remove duodenal SELs. The present study aimed to assess the feasibility and safety of endoscopic resection in combination with ligation (ER-L) for the removal of duodenal SELs. a total of 101 patients with duodenal SELs underwent ER-L from February 2010 to February 2020. The primary outcomes were complete resection, en bloc resection and R0 resection. The secondary outcomes included procedure duration, bleeding, perforation and residual lesions. A total of 101 patients with 101 duodenal SELs (ranged from 8.4 mm to 20.2 mm in size) were included in the study. most of the SELs (95.1 %) originated from the submucosal layer and were successfully removed using ER-L. The rates of complete resection, en bloc resection and R0 resection were 100 %, 96.0 % and 88.1 %, respectively. The median procedure duration was eight minutes. There were no severe complications, except for four patients who developed post-procedure bleeding (4.0 %) and recovered after conservative treatment. Furthermore, no residual lesions were detected during the follow-up period (median of 36 months). In fact, logistic regression analysis showed that the size of duodenal SELs was an independent factor for R0 resection during the ER-L procedure. in conclusion, ER-L is feasible and safe to remove duodenal SELs that originate from the submucosal layer and are less than 20 mm. However, the feasibility and safety of the ER-L should be further confirmed when removing the duodenal SELs that originate from the muscularis propria (MP) layer and are larger than 20 mm in diameter.