Application of endoscopic submucosal dissection in duodenal space-occupying lesions
作者机构：Department of GastroenterologyThe Affiliated Hospital of Qingdao UniversityQingdao 266003Shandong ProvinceChina Endoscopy CenterShandong Qingdao SanatoriumQingdao 266000Shandong ProvinceChina
出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)
年 卷 期：2020年第8卷第24期
页 面：6296-6305页
核心收录：
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
基 金：Supported by the National NaturalScience Foundation of China, No.81802777 the Shandong HigherEducation Research CenterScientific Research Project, No.YJKT201953 the ShandongProvince 2018 Professional DegreePostgraduate Teaching CaseLibrary Project, No. SDYAL18049 the Shandong Province 2018Postgraduate Mentoring AbilityImprovement Project, No.SDYY18073 and the "ClinicalMedicine + X" project of QingdaoUniversity Hospital
主 题：Endoscopic resection Submucosal dissection Space-occupying lesions Duodenal adenoma Duodenal lesions Complications
摘 要：BACKGROUNDEndoscopic submucosal dissection (ESD) has been advocated by digestiveendoscopists because of its comparable therapeutic effect to surgery, reducedtrauma, faster recovery, and fewer complications. However, ESD for lesions of theduodenum is more challenging than those occurring at other levels of thegastrointestinal tract due to the thin intestinal wall of the duodenum, narrowintestinal space, rich peripheral blood flow, proximity to vital organs, and highrisks of critical adverse events including intraoperative and delayed bleeding andperforation. Because of the low prevalence of the disease and the high risks ofsevere adverse events, successful ESD for lesions of the duodenum has rarelybeen reported in recent *** To investigate the efficacy and safety of ESD in the treatment of duodenal *** Clinical data of 24 cases of duodenal lesions treated by ESD at the DigestiveEndoscopy Center of the Affiliated Hospital of Qingdao University from January2016 to December 2019 were retrospectively *** All of the 24 cases from 23 patients underwent ESD treatment for duodenal spaceoccupyinglesions under general anesthesia, including 15 male and 8 femalepatients, with a mean age of 58.5 (32.0-74.0) years. There were 12 lesions (50%) inthe duodenal bulb, 9 (37.5%) in the descending part, and 3 (12.5%) in the ball descending junction. The mean diameter of the lesion was 12.75 (range, 11-22)mm. Thirteen lesions originated from the mucosa, of which 4 were low-gradeintraepithelial neoplasia, 3 were hyperplastic polyps, 2 were chronic mucositis, 2were adenomatous hyperplasia, 1 was high-grade intraepithelial neoplasia, and 1was tubular adenoma. Eleven lesions were in the submucosa, including 5neuroendocrine neoplasms, 2 cases of ectopic pancreas, 1 stromal tumor, 1leiomyoma, 1 submucosal duodenal adenoma, and 1 case of submucosal lymphfollicular hyperplasia. The intraoperative perforation rate was 20.8% (5/24),including 4 submucosal
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