Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors?
Abstract Objectives Underwater endoscopic mucosal resection (UEMR) is a simpler procedure for superficial non‐ampullary duodenal epithelial tumors (SNADET) than conventional endoscopic mucosal resection (cEMR). This study aimed to evaluate whether cEMR can be substituted by UEMR for SNADET in terms...
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Wiley
2024-04-01
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| Series: | DEN Open |
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| Online Access: | https://doi.org/10.1002/deo2.312 |
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| author | Hidenori Tanaka Yuji Urabe Hiroki Takemoto Kazuki Ishibashi Hirona Konishi Yuka Matsubara Yudai Takehara Shin Morimoto Fumiaki Tanino Noriko Yamamoto Hajime Teshima Junichi Mizuno Issei Hirata Hirosato Tamari Akiyoshi Tsuboi Ken Yamashita Takahiro Kotachi Hidehiko Takigawa Ryo Yuge Shiro Oka |
| author_facet | Hidenori Tanaka Yuji Urabe Hiroki Takemoto Kazuki Ishibashi Hirona Konishi Yuka Matsubara Yudai Takehara Shin Morimoto Fumiaki Tanino Noriko Yamamoto Hajime Teshima Junichi Mizuno Issei Hirata Hirosato Tamari Akiyoshi Tsuboi Ken Yamashita Takahiro Kotachi Hidehiko Takigawa Ryo Yuge Shiro Oka |
| author_sort | Hidenori Tanaka |
| collection | DOAJ |
| description | Abstract Objectives Underwater endoscopic mucosal resection (UEMR) is a simpler procedure for superficial non‐ampullary duodenal epithelial tumors (SNADET) than conventional endoscopic mucosal resection (cEMR). This study aimed to evaluate whether cEMR can be substituted by UEMR for SNADET in terms of effectiveness, safety, and learning curve. Methods A total of 157 consecutive patients with 203 SNADETs ≤20 mm in diameter, including 107 lesions resected by cEMR and 96 lesions resected by UEMR, between January 2019 and May 2023, were retrospectively recruited. The treatment outcomes were compared between the cEMR and UEMR groups. The risk factors for incomplete resection by UEMR were analyzed using univariate and multivariate analyses. Lesions in the UEMR group were divided chronologically into five periods; thereafter, the en bloc resection rate and procedure time were compared. Results No significant differences existed between the cEMR and UEMR groups in the mean procedure time (3.9 min vs. 3.6 min, p = 0.1380) or en bloc resection rate (91% vs. 94%, p = 0.4138). No perforation was observed in either group. Tumor size was an independent risk factor for incomplete resection using UEMR (p < 0.01). The history of biopsy was not associated with incomplete resection using UEMR. The en bloc resection rate of UEMR was 100% (20/20) in the first period and ranged from 90% to 100% over all periods. Conclusion UEMR is safe and effective for SNADET ≤20 mm, regardless of a history of biopsy, and is easy to learn. Thus, UEMR can serve as an alternative to cEMR. |
| format | Article |
| id | doaj-art-dec447262c7f4a33af15d33cb4c8119c |
| institution | Kabale University |
| issn | 2692-4609 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj-art-dec447262c7f4a33af15d33cb4c8119c2025-08-20T03:41:00ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.312Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors?Hidenori Tanaka0Yuji Urabe1Hiroki Takemoto2Kazuki Ishibashi3Hirona Konishi4Yuka Matsubara5Yudai Takehara6Shin Morimoto7Fumiaki Tanino8Noriko Yamamoto9Hajime Teshima10Junichi Mizuno11Issei Hirata12Hirosato Tamari13Akiyoshi Tsuboi14Ken Yamashita15Takahiro Kotachi16Hidehiko Takigawa17Ryo Yuge18Shiro Oka19Department of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima University Hospital Hiroshima JapanAbstract Objectives Underwater endoscopic mucosal resection (UEMR) is a simpler procedure for superficial non‐ampullary duodenal epithelial tumors (SNADET) than conventional endoscopic mucosal resection (cEMR). This study aimed to evaluate whether cEMR can be substituted by UEMR for SNADET in terms of effectiveness, safety, and learning curve. Methods A total of 157 consecutive patients with 203 SNADETs ≤20 mm in diameter, including 107 lesions resected by cEMR and 96 lesions resected by UEMR, between January 2019 and May 2023, were retrospectively recruited. The treatment outcomes were compared between the cEMR and UEMR groups. The risk factors for incomplete resection by UEMR were analyzed using univariate and multivariate analyses. Lesions in the UEMR group were divided chronologically into five periods; thereafter, the en bloc resection rate and procedure time were compared. Results No significant differences existed between the cEMR and UEMR groups in the mean procedure time (3.9 min vs. 3.6 min, p = 0.1380) or en bloc resection rate (91% vs. 94%, p = 0.4138). No perforation was observed in either group. Tumor size was an independent risk factor for incomplete resection using UEMR (p < 0.01). The history of biopsy was not associated with incomplete resection using UEMR. The en bloc resection rate of UEMR was 100% (20/20) in the first period and ranged from 90% to 100% over all periods. Conclusion UEMR is safe and effective for SNADET ≤20 mm, regardless of a history of biopsy, and is easy to learn. Thus, UEMR can serve as an alternative to cEMR.https://doi.org/10.1002/deo2.312duodenal neoplasmendoscopic mucosal resectionlearning curvesuperficial non‐ampullary duodenal epithelial tumorunderwater endoscopic mucosal resection |
| spellingShingle | Hidenori Tanaka Yuji Urabe Hiroki Takemoto Kazuki Ishibashi Hirona Konishi Yuka Matsubara Yudai Takehara Shin Morimoto Fumiaki Tanino Noriko Yamamoto Hajime Teshima Junichi Mizuno Issei Hirata Hirosato Tamari Akiyoshi Tsuboi Ken Yamashita Takahiro Kotachi Hidehiko Takigawa Ryo Yuge Shiro Oka Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors? DEN Open duodenal neoplasm endoscopic mucosal resection learning curve superficial non‐ampullary duodenal epithelial tumor underwater endoscopic mucosal resection |
| title | Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors? |
| title_full | Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors? |
| title_fullStr | Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors? |
| title_full_unstemmed | Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors? |
| title_short | Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors? |
| title_sort | can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non ampullary duodenal epithelial tumors |
| topic | duodenal neoplasm endoscopic mucosal resection learning curve superficial non‐ampullary duodenal epithelial tumor underwater endoscopic mucosal resection |
| url | https://doi.org/10.1002/deo2.312 |
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