Objective: We investigate the efficiency of endoscopic mucosal resection (EMR) of non-ampullary sporadic duodenal adenomas (NASDA) in a retrospective analysis with long-term follow-up. Methods: Consecutive patients undergoing EMR of NASDA between May 2002 and December 2016 were retrospectively identified from an electronic database. Endoscopic follow-up was scheduled after 3, 6 and 12 months for the first year, then yearly for up to five years. Results: EMR of 75 NASDA was performed in 68 patients (56% en-bloc, 44% piecemeal). Retroperitoneal perforations occurred in 3/68 (4.4%) patients, were treated by surgical (n = 2) or percutaneous (n = 1) drainage; delayed bleeding was reported in 13/75 (17.3%) resections and was successfully managed by endoscopy (n = 12) or radiologic embolization (n = 1). There was no procedure-related mortality. Follow-up was available in 61/68 patients (89.7%) after a median time of 59 months from resection. Residual and recurrent adenoma were diagnosed in 9 (14.5%) and 6 (10.9%) cases, respectively; all but one were successfully retreated endoscopically. Conclusions: EMR for NASDA is effective with a favorable long-term outcome. Local recurrences can be retreated endoscopically. A recall system, patient’s compliance to endoscopic follow-up are mandatory to detect recurrences and their prompt treatment.

Valerii, G., Tringali, A., Landi, R., Boškoski, I., Familiari, P., Bizzotto, A., Perri, V., Petruzziello, L., Costamagna, G., Endoscopic mucosal resection of non-ampullary sporadic duodenal adenomas: a retrospective analysis with long-term follow-up, <<SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY>>, 2018; (N/A): 1-5. [doi:10.1080/00365521.2018.1438508] [http://hdl.handle.net/10807/115987]

Endoscopic mucosal resection of non-ampullary sporadic duodenal adenomas: a retrospective analysis with long-term follow-up

Valerii, Giorgio;Tringali, Andrea
;
Landi, Rosario;Boškoski, Ivo;Familiari, Pietro;Bizzotto, Alessandra;Perri, Vincenzo;Petruzziello, Lucio;Costamagna, Guido
2018

Abstract

Objective: We investigate the efficiency of endoscopic mucosal resection (EMR) of non-ampullary sporadic duodenal adenomas (NASDA) in a retrospective analysis with long-term follow-up. Methods: Consecutive patients undergoing EMR of NASDA between May 2002 and December 2016 were retrospectively identified from an electronic database. Endoscopic follow-up was scheduled after 3, 6 and 12 months for the first year, then yearly for up to five years. Results: EMR of 75 NASDA was performed in 68 patients (56% en-bloc, 44% piecemeal). Retroperitoneal perforations occurred in 3/68 (4.4%) patients, were treated by surgical (n = 2) or percutaneous (n = 1) drainage; delayed bleeding was reported in 13/75 (17.3%) resections and was successfully managed by endoscopy (n = 12) or radiologic embolization (n = 1). There was no procedure-related mortality. Follow-up was available in 61/68 patients (89.7%) after a median time of 59 months from resection. Residual and recurrent adenoma were diagnosed in 9 (14.5%) and 6 (10.9%) cases, respectively; all but one were successfully retreated endoscopically. Conclusions: EMR for NASDA is effective with a favorable long-term outcome. Local recurrences can be retreated endoscopically. A recall system, patient’s compliance to endoscopic follow-up are mandatory to detect recurrences and their prompt treatment.
Inglese
Valerii, G., Tringali, A., Landi, R., Boškoski, I., Familiari, P., Bizzotto, A., Perri, V., Petruzziello, L., Costamagna, G., Endoscopic mucosal resection of non-ampullary sporadic duodenal adenomas: a retrospective analysis with long-term follow-up, <>, 2018; (N/A): 1-5. [doi:10.1080/00365521.2018.1438508] [http://hdl.handle.net/10807/115987]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/115987
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