Büyük yüzeyel duodenal epitelyal neoplazi tedavisinde endoskopik submukozal diseksiyonun rolü

Öz

Giriş ve Amaç: Endoskopik submukozal diseksiyon, 2 cm'den büyük yüzeyel duodenal epitelyal neoplazmı olan hastalarda en-blok rezeksiyonun kolaylaştırılması açısından önerilen tedavi yöntemlerinden biridir. Literatürde endoskopik submukozal diseksiyonun yüzeyel duodenal epitelyal neoplazmda uygulanabilirliği hakkında sınırlı bilgi bulunmaktadır. Bu çalışmada endoskopik submukozal diseksiyon uygulanan sekiz yüzeyel duodenal epitelyal neoplasm hastasının sonuçları retrospektif olarak analiz edildi. Gereç ve Yöntem: Şubat 2019 ile Kasım 2023 tarihleri arasında duodenal endoskopik submukozal diseksiyon uygulanan 12 hasta tarandı. Yüzeyel duodenal epitelyal neoplazmi 2 cm'den büyük olan 8 hasta çalışmaya dahil edildi. Bulgular: Medyan tümör çapı 27.5 mm (20 - 80 mm) idi. En sık lokalizasyon duodenumun ikinci kısmıydı (%87.5). En blok ve R0 rezeksiyon oranlarının her biri %100 idi. Ortalama işlem süresi 37.5 dakika idi. Komplikasyon gelişen iki hasta (%20) endoskopik kliplerle tedavi edildi. Hastaların tamamında (ortalama 21 ay) nüks görülmedi. Sonuç: Endoskopik submukozal diseksiyon, yüzeyel duodenal epitelyal neoplazm tedavisinde teknik açıdan zor ancak başarılı bir yöntemdir. Komplikasyon riskinin yüksek olması nedeniyle duodenal endoskopik submukozal diseksiyon deneyimli merkezlerde yapılmalıdır.

Anahtar Kelimeler

• Duodenum
• endoskopik submukozal diseksiyon
• neoplazi

The role of endoscopic submucosal dissection in the treatment of large superficial duodenal epithelial neoplasia

Öz

Background and Aims: Endoscopic submucosal dissection is one of the recommended treatment modality in terms of facilitating en-bloc resection in patients with superficial duodenal epithelial neoplasm larger than 2 cm. There is limited information in the literature about the applicability of endoscopic submucosal dissection in superficial duodenal epithelial neoplasm. In this single-center study, the results of eight patients with superficial duodenal epithelial neoplasm who underwent endoscopic submucosal dissection were retrospectively analyzed. Materials and Methods: Twelve patients who underwent duodenal endoscopic submucosal dissection between February 2019 and November 2023 were screened. Eight patients with superficial duodenal epithelial neoplasm larger than 2 cm were included in the study. Results: The median tumor diameter was 27.5 mm (20 - 80 mm). The most common localization was the duodenum second part (87.5%). En bloc and R0 resection rates were each 100%. The median procedure time was 37.5 min. Two patients (20%) with complications were treated with endoscopic clips. No recurrence was observed in all patients (mean 21 months). Conclusion: Endoscopic submucosal dissection is a technically challenging but successful method in the treatment of superficial duodenal epithelial neoplasm. Due to the high risk of complications, duodenal endoscopic submucosal dissection should be performed in experienced centers.

Anahtar Kelimeler

• Duodenum
• endoscopic submucosal dissection
• neoplasia

Kaynakça

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