Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Nov 16, 2022; 14(11): 684-693
Published online Nov 16, 2022. doi: 10.4253/wjge.v14.i11.684
Effectiveness and safety of endoscopic resection for duodenal gastrointestinal stromal tumors: A single center analysis
Zhen-Zhen Wang, Xiao-Dan Yan, Hai-Deng Yang, Xin-Li Mao, Yue Cai, Xin-Yu Fu, Shao-Wei Li
Zhen-Zhen Wang, Shao-Wei Li, Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai 315000, Zhejiang Province, China
Zhen-Zhen Wang, Xiao-Dan Yan, Hai-Deng Yang, Xin-Li Mao, Yue Cai, Shao-Wei Li, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai 315000, Zhejiang Province, China
Zhen-Zhen Wang, Shao-Wei Li, Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai 315000, Zhejiang Province, China
Xin-Yu Fu, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai 315000, Zhejiang Province, China
Author contributions: Wang ZZ, Mao XL, Yan XD, and Yang HD participated in the clinical treatment; Wang ZZ, Fu XY, and Cai Y wrote the original draft; Li SW undertook validation, writing, reviewing, and editing; All authors contributed to the article and approved the submitted version.
Supported by Medical Science and Technology Project of Zhejiang Province, No. 2021PY083; Program of Taizhou Science and Technology Grant, No. 22ywb09; Major Research Program of Taizhou Enze Medical Center Grant, No. 19EZZDA2; Open Project Program of Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, No. 21SZDSYS01 and 21SZDSYS09; Key Technology Research and Development Program of Zhejiang Province, No. 2019C03040; and Program of Taizhou Science and Technology Grant, No. 1901ky18.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University Institutional Review Board (Approval No. K20210611).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shao-Wei Li, MD, Associate Professor, Research Assistant Professor, Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital Affiliated to Wenzhou Medical University, Ximen Street No. 150 Linhai 315000, Zhejiang Province, China. li_shaowei81@hotmail.com
Received: August 28, 2022
Peer-review started: August 28, 2022
First decision: September 12, 2022
Revised: September 28, 2022
Accepted: October 27, 2022
Article in press: October 27, 2022
Published online: November 16, 2022
Abstract
BACKGROUND

Endoscopic resection for duodenal gastrointestinal stromal tumors (GISTs) is still considered a great challenge with a high risk of complications, including perforation, bleeding, tumor rupture, and residual tumor.

AIM

To assess the effectiveness and safety of endoscopic resection for duodenal GISTs.

METHODS

Between January 2010 and January 2022, 11 patients with duodenal GISTs were treated with endoscopic resection. Data were extracted for the incidence of complete resection, bleeding, perforation, postoperative infection, recurrence, and distant metastasis.

RESULTS

The incidence of successful complete resection of duodenal GISTs was 100%. Three cases (27.3%) had suspected positive margins, and the other 8 cases (72.7%) had negative vertical and horizontal margins. Perforation occurred in all 11 patients. The success rate of perforation closure was 100%, while 1 patient (9.1%) had suspected delayed perforation. All bleeding during the procedure was managed by endoscopic methods. One case (9.1%) had delayed bleeding. Postoperative infection occurred in 6 patients (54.5%), including 1 who developed septic shock and 1 who developed a right iliac fossa abscess. All 11 patients recovered and were discharged. The mean hospital stay was 15.3 d. During the follow-up period (14-80 mo), duodenal stenosis occurred in 1 case (9.1%), and no local recurrence or distant metastasis were detected.

CONCLUSION

Endoscopic resection for duodenal GISTs appears to be an effective and safe minimally invasive treatment when performed by an experienced endoscopist.

Keywords: Duodenal tumor, Gastrointestinal stromal tumors, Treatment, Endoscopic resection, Effectiveness, Safety

Core Tip: This study presents the findings on endoscopic resection for duodenal gastrointestinal stromal tumors. Endoscopic resection of duodenal gastrointestinal stromal tumors is a great challenge. This study aimed to assess the effectiveness and safety of endoscopic resection for duodenal gastrointestinal stromal tumors. The rate of successful complete resection was 100%. Intraoperative perforation occurred in all 11 patients. The success rate of perforation closure was 100%. All 11 patients recovered. During the follow-up period (14-80 mo), duodenal stenosis occurred in 1 case (9.1%), and no local recurrence or distant metastases were detected.