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

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 wa...

Full description

Saved in:
Bibliographic Details
Main Authors: Yoshie Nomoto, Satoshi Shinozaki, Yoshimasa Miura, Hiroyuki Osawa, Yuji Ino, Tomonori Yano, Nikolaos Lazaridis, Hironori Yamamoto
Format: Article
Language:English
Published: Korean Society of Gastrointestinal Endoscopy 2025-07-01
Series:Clinical Endoscopy
Subjects:
Online Access:http://e-ce.org/upload/pdf/ce-2024-181.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850069474661629952
author Yoshie Nomoto
Satoshi Shinozaki
Yoshimasa Miura
Hiroyuki Osawa
Yuji Ino
Tomonori Yano
Nikolaos Lazaridis
Hironori Yamamoto
author_facet Yoshie Nomoto
Satoshi Shinozaki
Yoshimasa Miura
Hiroyuki Osawa
Yuji Ino
Tomonori Yano
Nikolaos Lazaridis
Hironori Yamamoto
author_sort Yoshie Nomoto
collection DOAJ
description 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=0.02), 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=0.02). 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.
format Article
id doaj-art-3cf9297554fc4be2833e57bc30a30705
institution DOAJ
issn 2234-2400
2234-2443
language English
publishDate 2025-07-01
publisher Korean Society of Gastrointestinal Endoscopy
record_format Article
series Clinical Endoscopy
spelling doaj-art-3cf9297554fc4be2833e57bc30a307052025-08-20T02:47:46ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432025-07-0158456156810.5946/ce.2024.1817968Utility of underwater endoscopic mucosal resection combined with a protruding anchor by saline injection for superficial non-ampullary duodenal tumors: a retrospective study in JapanYoshie Nomoto0Satoshi Shinozaki1Yoshimasa Miura2Hiroyuki Osawa3Yuji Ino4Tomonori Yano5Nikolaos Lazaridis6Hironori Yamamoto7 Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan Royal Free Unit for Endoscopy, The Royal Free Hospital and UCL Institute for Liver and Digestive Health, London, UK Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, JapanBackground/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=0.02), 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=0.02). 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.http://e-ce.org/upload/pdf/ce-2024-181.pdfduodenal neoplasmsendoscopic mucosal resectionendoscopypatient outcome assessment
spellingShingle Yoshie Nomoto
Satoshi Shinozaki
Yoshimasa Miura
Hiroyuki Osawa
Yuji Ino
Tomonori Yano
Nikolaos Lazaridis
Hironori Yamamoto
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
Clinical Endoscopy
duodenal neoplasms
endoscopic mucosal resection
endoscopy
patient outcome assessment
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic duodenal neoplasms
endoscopic mucosal resection
endoscopy
patient outcome assessment
url http://e-ce.org/upload/pdf/ce-2024-181.pdf
work_keys_str_mv AT yoshienomoto utilityofunderwaterendoscopicmucosalresectioncombinedwithaprotrudinganchorbysalineinjectionforsuperficialnonampullaryduodenaltumorsaretrospectivestudyinjapan
AT satoshishinozaki utilityofunderwaterendoscopicmucosalresectioncombinedwithaprotrudinganchorbysalineinjectionforsuperficialnonampullaryduodenaltumorsaretrospectivestudyinjapan
AT yoshimasamiura utilityofunderwaterendoscopicmucosalresectioncombinedwithaprotrudinganchorbysalineinjectionforsuperficialnonampullaryduodenaltumorsaretrospectivestudyinjapan
AT hiroyukiosawa utilityofunderwaterendoscopicmucosalresectioncombinedwithaprotrudinganchorbysalineinjectionforsuperficialnonampullaryduodenaltumorsaretrospectivestudyinjapan
AT yujiino utilityofunderwaterendoscopicmucosalresectioncombinedwithaprotrudinganchorbysalineinjectionforsuperficialnonampullaryduodenaltumorsaretrospectivestudyinjapan
AT tomonoriyano utilityofunderwaterendoscopicmucosalresectioncombinedwithaprotrudinganchorbysalineinjectionforsuperficialnonampullaryduodenaltumorsaretrospectivestudyinjapan
AT nikolaoslazaridis utilityofunderwaterendoscopicmucosalresectioncombinedwithaprotrudinganchorbysalineinjectionforsuperficialnonampullaryduodenaltumorsaretrospectivestudyinjapan
AT hironoriyamamoto utilityofunderwaterendoscopicmucosalresectioncombinedwithaprotrudinganchorbysalineinjectionforsuperficialnonampullaryduodenaltumorsaretrospectivestudyinjapan