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...
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Korean Society of Gastrointestinal Endoscopy
2025-07-01
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| Series: | Clinical Endoscopy |
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| Online Access: | http://e-ce.org/upload/pdf/ce-2024-181.pdf |
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| 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 |
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