自体十二指肠黏膜移植

Q3 Medicine

VideoGIE Pub Date : 2025-10-01 DOI:10.1016/j.vgie.2025.05.014

Kambiz Kadkhodayan MD , Shayan Irani MD , Saurabh Chandan MD , Sagar Pathak MD , Maham Hayat MD , Abdullah Abbasi MD , Muhammad K. Hasan MD, FACG, FRCP (Glasg) , Natalie Cosgrove MD , Deepanshu Jain MD , Dennis Yang MD , Charanjeet Singh MD

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引用次数: 0

摘要

背景与目的十二指肠大病变内镜黏膜切除术（EMR）后，大缺损和术后狭窄的闭合是具有挑战性的。十二指肠黏膜自体移植（DAT）可能为十二指肠大病变切除术患者提供一种新的修复缺陷和预防狭窄的策略。方法对57岁女性患者行十二指肠腺瘤的EMR切片检查，检查面积为管腔周长的60%。采用标准EMR技术从邻近十二指肠取下2 × 2 cm的自体粘膜移植物，并使用螺旋钉和止血夹固定在切除床上。这导致缺损完全闭合而不损害管腔。结果随访EGD 6周，我们观察到移植物结合，螺旋钉和夹完整，未见十二指肠狭窄形成迹象。活体组织检查证实，受者部位粘膜健康，供者部位愈合良好。组织病理学显示存活的十二指肠黏膜伴黏膜下纤维化。6个月时的EGD显示供体和受体部位愈合良好，无狭窄形成的证据。结论sdat是一种可行的十二指肠缺损修补技术，可降低狭窄风险。需要进一步的研究来评估这种方法的长期结果和更广泛的适用性。

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Duodenal mucosal autotransplantation

Background and Aims

Closure of large defects and postresection strictures can be challenging to manage after endoscopic mucosal resection (EMR) of large duodenal lesions. Duodenal mucosal autotransplantation (DAT) may offer a new strategy for defect closure and stricture prevention in patients that undergo resection of large lesions in the duodenum.

Methods

A 57-year-old female underwent piecemeal EMR of a duodenal adenoma involving 60% of the luminal circumference. A mucosal autograft (2 x 2 cm) was harvested from adjacent duodenum using standard EMR technique and fixed to the resection bed using helical tacks and hemostatic clips. This resulted in complete defect closure without luminal compromise.

Results

On follow-up EGD at 6 weeks, we noted graft incorporation, intact helix tacks and clips, and no evidence of duodenal stricture formation. The recipient site showed healthy mucosa, confirmed by biopsy, and the donor site healed well. Histopathology revealed viable duodenal mucosa with submucosal fibrosis. EGD at 6 months revealed well-healed donor and recipient sites, without evidence of stricture formation.

Conclusions

DAT is a feasible technique for closure of large duodenal defects and may reduce stricture risk. Further studies are warranted to evaluate long-term outcomes and broader applicability of this approach.

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.