Clinical Endoscopy

Original Article

Utility of underwater endoscopic mucosal resection combined with a protruding anchor by saline injection for superficial non-ampullary duodenal tumors: a retrospective study in Japan: Yoshie Nomoto, Satoshi Shinozaki, Yoshimasa Miura, Hiroyuki Osawa, Yuji Ino, Tomonori Yano, Nikolaos Lazaridis, Hironori Yamamoto; Received July 4, 2024 Accepted September 30, 2024 Published online March 12, 2025; DOI: https://doi.org/10.5946/ce.2024.181 [Epub ahead of print]

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Underwater endoscopic mucosal resection (UEMR) is the standard resection method for superficial non-ampullary duodenal tumors (SNADETs). We developed a novel UEMR technique that creates an anchor by protruding the distal fold with a saline injection (UEMR-A). The aim of this study was to clarify the usefulness of UEMR-A compared to conventional UEMR (UEMR-C).
Methods
This retrospective observational study included patients who underwent UEMR for SNADETs.
Results
A total of 141 patients were included and divided into UEMR-A (n=54) and UEMR-C (n=87) groups. Lesion resection was performed significantly more frequently by an expert endoscopist in the UEMR-C group compared to the UEMR-A group (p<0.001). The procedure time for UEMR-A was significantly shorter than that for UEMR-C (p=0.018), despite the additional time required for submucosal injection. The R0 resection rate was significantly higher in the UEMR-A group than in the UEMR-C group (p=0.004). The horizontal margins were significantly clearer in the UEMR-A group than in the UEMR-C group (p=0.018). Multivariate analysis revealed that the use of UEMR-A was the only significant positive factor for R0 resection.
Conclusions
The UEMR-A technique for SNADETs appears to improve R0 resection rates and reduce procedure times compared to the UEMR-C technique.

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Case Report

A Patient with Duodenal Mucinous Adenocarcinoma Presenting as a Laterally Spreading Tumor: Myung Joon Chae, Il Hyun Baek, Yu Mi Oh, Jun Uk Lim, Jung Won Jeon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee; Clin Endosc 2015;48(4):336-339. Published online July 24, 2015; DOI: https://doi.org/10.5946/ce.2015.48.4.336

Abstract PDF PubReader ePub

Primary duodenal carcinoma is rare. Duodenal mucinous adenocarcinoma (DMA) is even rarer, and its associated manifestations and typical endoscopic or imaging findings are not well characterized. Herein, we report a case of primary DMA in an asymptomatic 58-year-old man who visited our hospital for a regular health screening. Upper endoscopy revealed an approximately 4-cm lesion in the second portion of the duodenum, but the mass was not visualized on computed tomography. Biopsies revealed a tubular adenoma that was subsequently resected. Frozen biopsies demonstrated DMA with a background of low-grade tubular adenoma for which we performed Roux-en-Y duodenojejunostomy and jejunojejunostomy. To our knowledge, this is the first report of a patient with DMA in Korea.

Citations

Citations to this article as recorded by

Duodenal Mucinous Adenocarcinoma in a Patient With Immunodeficiency: A Case Report
Timon Sseruwagi, Joel Musinzi, William M Mutumba, Catherine Lewis
Cureus.2023;[Epub] CrossRef
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Roy Holland, Offir Ben-Ishay, Irit Ben-Aharon
Frontiers in Oncology.2022;[Epub] CrossRef
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Molecular and Clinical Oncology.2018;[Epub] CrossRef
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Abdominal Radiology.2017; 42(11): 2686. CrossRef
Two Cases of Duodenal Mucinous Carcinoma
Motoki YAMAMOTO, Makoto IWAHASHI, Hiroshi TERASAWA, Shimpei MARUOKA, Yukari TSUBOTA
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2016; 77(11): 2716. CrossRef

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