Li XY, Ji KY, Qu YH, Zheng JJ, Guo YJ, Zhang CP, Zhang KP. Application of endoscopic submucosal dissection in duodenal space-occupying lesions. World J Clin Cases 2020; 8(24): 6296-6305 [PMID: 33392310 DOI: 10.12998/wjcc.v8.i24.6296]
Corresponding Author of This Article
Kun-Peng Zhang, PhD, Doctor, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, No 16 Jiangsu Road, Qingdao 266000, Shandong Province, China. zhangkp17@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Xiao-Yu Li, Kai-Yue Ji, Juan-Juan Zheng, Ying-Jie Guo, Cui-Ping Zhang, Kun-Peng Zhang, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Yu-Hu Qu, Endoscopy Center, Shandong Qingdao Sanatorium, Qingdao 266000, Shandong Province, China
Author contributions: Li XY and Ji KY contributed equally to this work and should be regarded as co-first authors, and they collected the clinical data and wrote the manuscript; Qu YH, Zheng JJ, and Guo YJ contributed to clinical data collection and follow-up; Zhang CP directed the study and reviewed the final manuscript; Zhang KP performed the endoscopic resection for the patient and revised the article.
Supported bythe National Natural Science Foundation of China, No. 81802777; the Shandong Higher Education Research Center Scientific Research Project, No. YJKT201953; the Shandong Province 2018 Professional Degree Postgraduate Teaching Case Library Project, No. SDYAL18049; the Shandong Province 2018 Postgraduate Mentoring Ability Improvement Project, No. SDYY18073; and the "Clinical Medicine + X" project of Qingdao University Hospital.
Institutional review board statement: The study was reviewed and approved by the Affiliated Hospital of Qingdao University Institutional Review Board.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict 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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kun-Peng Zhang, PhD, Doctor, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, No 16 Jiangsu Road, Qingdao 266000, Shandong Province, China. zhangkp17@126.com
Received: August 26, 2020 Peer-review started: August 26, 2020 First decision: September 13, 2020 Revised: September 15, 2020 Accepted: September 25, 2020 Article in press: September 25, 2020 Published online: December 26, 2020 Processing time: 114 Days and 17.2 Hours
ARTICLE HIGHLIGHTS
Research background
Endoscopic submucosal dissection (ESD) for lesions of the duodenum is more challenge than those occurring at other levels of the gastrointestinal tract due to the thin intestinal wall of the duodenum, narrow intestinal space, rich peripheral blood flow, proximity to vital organs, and high risks of critical adverse events including intraoperative and delayed bleeding and perforation. Because of the low prevalence of the disease and the high risks of severe adverse events, successful ESD for lesions of the duodenum has rarely been reported in recent years.
Research motivation
To investigate the efficacy and safety of ESD in the treatment of duodenal space-occupying lesions.
Research objectives
Based on the research background, we analyzed the clinical data of 24 cases of duodenal lesions treated by ESD and investigated the effectiveness of ESD in these cases.
Research methods
This study analyzed the clinical data of 24 cases of duodenal lesions treated by ESD at the Digestive Endoscopy Center of the Affiliated Hospital of Qingdao University from January 2016 to December 2019 and investigated the complications and hands-on experiences.
Research results
Bleeding and perforation were the main adverse events. The intraoperative perforation rate was 20.8% (5/24), including 4 submucosal protuberant lesions and 1 depressed lesion. No residual disease or recurrence was found in all patients, and no complications, such as infection and stenosis, were found during a median follow-up period of 25.8 mo. No patient died due to tumor recurrence.
Research conclusions
ESD is safe and effective in the treatment of duodenal lesions; however, the endoscopists should pay more attention to the preoperative preparation, intraoperative skills, and postoperative treatment.
