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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Main Authors: 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
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
Subjects:
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.
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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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