Yuting Jiang, Zeliang Yang, Caihao Lin, Jie Yang, Xiaoling Zheng
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The accuracies of EUS in determining the pathological type and origin of the lesions were evaluated using postoperative histopathology as the gold standard.</p><p><strong>Results: </strong>Overall, 56 patients with NADSELs underwent ER in this study, including 16 and 40 treated with pEMR and ESD, respectively. There were no significant differences between the two groups in terms of en bloc resection rate, complete (R0) resection rate, perioperative complication rate, and postoperative hospital length of stay (P > 0.05). However, the pEMR group had significantly shorter median operational (13.0 min vs. 30.5 min, P < 0.001) and mean fasting (1.9 days vs. 2.8 days, P = 0.006) time and lower median hospital costs (¥12,388 vs. ¥19,579, P = 0.002). The accuracies of EUS in determining the pathological type and origin of the lesions were 76.8% and 94.6%, respectively, compared with histopathological evaluation.</p><p><strong>Conclusions: </strong>EUS can accurately predict the origin of NADSELs. 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The accuracies of EUS in determining the pathological type and origin of the lesions were evaluated using postoperative histopathology as the gold standard.</p><p><strong>Results: </strong>Overall, 56 patients with NADSELs underwent ER in this study, including 16 and 40 treated with pEMR and ESD, respectively. There were no significant differences between the two groups in terms of en bloc resection rate, complete (R0) resection rate, perioperative complication rate, and postoperative hospital length of stay (P > 0.05). However, the pEMR group had significantly shorter median operational (13.0 min vs. 30.5 min, P < 0.001) and mean fasting (1.9 days vs. 2.8 days, P = 0.006) time and lower median hospital costs (¥12,388 vs. ¥19,579, P = 0.002). 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引用次数: 0
摘要
目的:本研究旨在评估内镜黏膜下剥离术(ESD)和内镜黏膜切除术(pEMR)治疗非髓质十二指肠上皮下病变(NADSELs)的安全性和有效性,并评估内镜切除术(ER)前内镜超声(EUS)的临床实用性:在这项回顾性单中心队列研究中,我们比较了2014年1月至2023年6月期间接受ESD或pEMR的NADSEL患者的临床结果。以术后组织病理学作为金标准,评估了 EUS 确定病变类型和来源的准确性:本研究中共有 56 名 NADSELs 患者接受了 ER 治疗,其中分别有 16 名和 40 名患者接受了 pEMR 和 ESD 治疗。两组患者在全切率、完全(R0)切除率、围术期并发症发生率和术后住院时间方面无明显差异(P>0.05)。然而,pEMR 组的中位手术时间明显更短(13.0 分钟 vs. 30.5 分钟,P 结论:EUS 可以准确预测肿瘤的位置:EUS 可以准确预测 NADSEL 的起源。使用 EUS 确定病变起源于粘膜下层或更表层的合适病变可使用 pEMR 治疗,因为它缩短了手术和恢复时间,降低了住院费用,并实现了与 ESD 相似的 R0 切除率。
Endoscopic resection for non-ampullary duodenal subepithelial lesions: a retrospective cohort study.
Purpose: This study aimed to assess the safety and efficacy of endoscopic submucosal dissection (ESD) and pre-cutting endoscopic mucosal resection (pEMR) in treating non-ampullary duodenal subepithelial lesions (NADSELs) and to evaluate the clinical utility of endoscopic ultrasound (EUS) before endoscopic resection (ER).
Methods: In this retrospective single-centre cohort study, we compared the clinical outcomes of patients with NADSELs who underwent ESD or pEMR between January 2014 and June 2023. The accuracies of EUS in determining the pathological type and origin of the lesions were evaluated using postoperative histopathology as the gold standard.
Results: Overall, 56 patients with NADSELs underwent ER in this study, including 16 and 40 treated with pEMR and ESD, respectively. There were no significant differences between the two groups in terms of en bloc resection rate, complete (R0) resection rate, perioperative complication rate, and postoperative hospital length of stay (P > 0.05). However, the pEMR group had significantly shorter median operational (13.0 min vs. 30.5 min, P < 0.001) and mean fasting (1.9 days vs. 2.8 days, P = 0.006) time and lower median hospital costs (¥12,388 vs. ¥19,579, P = 0.002). The accuracies of EUS in determining the pathological type and origin of the lesions were 76.8% and 94.6%, respectively, compared with histopathological evaluation.
Conclusions: EUS can accurately predict the origin of NADSELs. Suitable lesions determined to originate from the submucosa or more superficial layers using EUS can be treated using pEMR as it shortens the operational and recovery time, reduces hospitalisation costs, and achieves an R0 resection rate similar to ESD.
期刊介绍:
The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies.
The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.