{"title":"内镜下粘膜夹层与内镜乳头切除术治疗十二指肠乳头状肿瘤的有效性和安全性。","authors":"Yuki Kano, Ken Ohata, Toshifumi Iida, Susumu Banjoya, Tomoya Kimura, Koichi Furuta, Shinya Nagae, Yohei Ito, Hiroshi Yamazaki, Nao Takeuchi, Shunya Takayanagi, Yoshiaki Kimoto, Yuji Koyama, Seitaro Tsujino, Takashi Sakuno, Kohei Ono, Yohei Minato, Yuji Fujita, Eiji Sakai, Hideyuki Chiba","doi":"10.5946/ce.2025.066","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>Endoscopic submucosal dissection (ESD) can be performed to treat laterally spreading duodenal papillary tumors (LSPTs). However, no studies have been conducted on the outcomes of ESDs for LSPTs.</p><p><strong>Methods: </strong>We retrospectively compared 47 patients who underwent endoscopic papillectomies (EPs) for papillary tumors (PTs) between June 2007 and July 2023 (EP group) and eight patients who underwent ESDs for LSPTs between February 2022 and July 2023 (ESD group). In the subgroup analysis, five patients who underwent EPs for LSPTs were compared with eight patients who underwent ESDs for LSPTs.</p><p><strong>Results: </strong>Procedure times and tumor diameters were significantly greater in the ESD group than in the EP group. The positive or unclear vertical margin (VM1/X) rate was significantly higher in the ESD group. Additional therapies were administered for patients with VM1/X in the ESD group, and no local recurrence was observed. No delayed adverse events occurred in the ESD group; however, delayed bleeding and perforation occurred in the EP group. In the subgroup analysis, the en bloc resection rate was significantly higher in the ESD group than in the EP group. The VM1/X rate did not differ significantly between groups.</p><p><strong>Conclusions: </strong>We suggest that ESD is both feasible and safe for LSPTs.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"712-721"},"PeriodicalIF":2.3000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489559/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of endoscopic submucosal dissection versus endoscopic papillectomy for managing laterally spreading duodenal papillary tumors.\",\"authors\":\"Yuki Kano, Ken Ohata, Toshifumi Iida, Susumu Banjoya, Tomoya Kimura, Koichi Furuta, Shinya Nagae, Yohei Ito, Hiroshi Yamazaki, Nao Takeuchi, Shunya Takayanagi, Yoshiaki Kimoto, Yuji Koyama, Seitaro Tsujino, Takashi Sakuno, Kohei Ono, Yohei Minato, Yuji Fujita, Eiji Sakai, Hideyuki Chiba\",\"doi\":\"10.5946/ce.2025.066\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aim: </strong>Endoscopic submucosal dissection (ESD) can be performed to treat laterally spreading duodenal papillary tumors (LSPTs). However, no studies have been conducted on the outcomes of ESDs for LSPTs.</p><p><strong>Methods: </strong>We retrospectively compared 47 patients who underwent endoscopic papillectomies (EPs) for papillary tumors (PTs) between June 2007 and July 2023 (EP group) and eight patients who underwent ESDs for LSPTs between February 2022 and July 2023 (ESD group). In the subgroup analysis, five patients who underwent EPs for LSPTs were compared with eight patients who underwent ESDs for LSPTs.</p><p><strong>Results: </strong>Procedure times and tumor diameters were significantly greater in the ESD group than in the EP group. The positive or unclear vertical margin (VM1/X) rate was significantly higher in the ESD group. Additional therapies were administered for patients with VM1/X in the ESD group, and no local recurrence was observed. No delayed adverse events occurred in the ESD group; however, delayed bleeding and perforation occurred in the EP group. In the subgroup analysis, the en bloc resection rate was significantly higher in the ESD group than in the EP group. The VM1/X rate did not differ significantly between groups.</p><p><strong>Conclusions: </strong>We suggest that ESD is both feasible and safe for LSPTs.</p>\",\"PeriodicalId\":10351,\"journal\":{\"name\":\"Clinical Endoscopy\",\"volume\":\" \",\"pages\":\"712-721\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489559/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Endoscopy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5946/ce.2025.066\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Endoscopy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5946/ce.2025.066","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Efficacy and safety of endoscopic submucosal dissection versus endoscopic papillectomy for managing laterally spreading duodenal papillary tumors.
Background/aim: Endoscopic submucosal dissection (ESD) can be performed to treat laterally spreading duodenal papillary tumors (LSPTs). However, no studies have been conducted on the outcomes of ESDs for LSPTs.
Methods: We retrospectively compared 47 patients who underwent endoscopic papillectomies (EPs) for papillary tumors (PTs) between June 2007 and July 2023 (EP group) and eight patients who underwent ESDs for LSPTs between February 2022 and July 2023 (ESD group). In the subgroup analysis, five patients who underwent EPs for LSPTs were compared with eight patients who underwent ESDs for LSPTs.
Results: Procedure times and tumor diameters were significantly greater in the ESD group than in the EP group. The positive or unclear vertical margin (VM1/X) rate was significantly higher in the ESD group. Additional therapies were administered for patients with VM1/X in the ESD group, and no local recurrence was observed. No delayed adverse events occurred in the ESD group; however, delayed bleeding and perforation occurred in the EP group. In the subgroup analysis, the en bloc resection rate was significantly higher in the ESD group than in the EP group. The VM1/X rate did not differ significantly between groups.
Conclusions: We suggest that ESD is both feasible and safe for LSPTs.
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