Clinical outcomes of ligation-assisted endoscopic resection for duodenal neuroendocrine tumors. Issue 18 (May 2018)

• Record Type: Journal Article
• Authors: Park, Su Bum; Kang, Dae Hwan; Choi, Cheol Woong; Kim, Hyung Wook; Kim, Su Jin
• Other Names: Kantarçeken. Bülent section editor.
• Is Part Of: Medicine. Volume 97:Issue 18(2018)
• Publication Date: 2018-05
• Subjects: endoscopic mucosal resection -- ligation -- neoplasia -- neuroendocrine tumor; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000010533
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Duodenal carcinoid tumors, a type of neuroendocrine tumors, are relatively rare and are usually found incidentally during endoscopy. Small duodenal carcinoid tumors (⩽10–20 mm), embedded in the submucosa, can be resected endoscopically because of the low risk of metastasis. The aim of this study was to assess the safety and efficacy of ligation-assisted endoscopic mucosal resection (EMR) for the treatment of small duodenal carcinoid tumors. The clinical outcomes of the endoscopic procedures were also evaluated. Between November 2008 and November 2017, a total of 15 duodenal carcinoid tumors embedded in the submucosa were resected using EMR. Two types of EMR (conventional EMR and ligation-assisted EMR) were performed according to tumor morphology (narrow-based and broad-based). The mean tumor size was 6.6 ± 3.9 mm and the mean procedure time was 11.0 ± 11.2 minutes. Most of the lesions (80.0%) were located in the duodenal 1st portion. Broad-based tumors were more common than narrow-based tumors (66.7% vs 33.3%). All broad-based tumors were resected successfully using ligation-assisted EMR. Although en-bloc resection and complete resection rates were higher in ligation-assisted EMR than in conventional EMR ([100% vs 87.5%], and [85.7% vs 62.5%], respectively), the difference was not significant ( P = .333 and P = .310, respectively). Moreover, there was no evidence of local or distant metastasis during the follow-up (26.1 ± 20.7 months). Ligation-assisted EMR showed a higher complete resection rate than conventional EMR. Ligation-assisted EMR may be an optimal treatment option for duodenal carcinoid tumors with a broad base.