Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6296
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
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.
To investigate the efficacy and safety of ESD in the treatment of duodenal space-occupying lesions.
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.
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.
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.
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.
For duodenal lesions, ESD is safe and effective.