Feasibility study comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for superficial non-ampullary duodenal epithelial tumor < 20 mm

摘要

Background and Aim Underwater endoscopic mucosal resection (UEMR) has been reported as an alternative to conventionalEMRfor superficial non-ampullary duodenal epithelial tumors (SNADET). However, the detailed outcomes are unclear. This study aimed to compare the clinical outcomes betweenUEMRandEMRforSNADET This is a retrospective observational study using a prospective maintained database. From November 2017 to December 2018, 104 consecutive cases of attemptedUEMRforSNADETEMRwere chosen as historical controls. We compared technical success rate, defined as the resection rate without conversion toESD; en bloc resection rate; R0 resection rate; and adverse event rate. Next, multivariate analyses were constructed to identify predictors of conversion toESD, piecemeal resection, andRXor R1 (RX/R1) resection. Results Technical success rate ofUEMRwas significantly higher than that ofEMR(87% and 70%,P < 0.01). En bloc resection and R0 resection rates ofUEMRwere significantly lower than those ofEMR(en bloc resection: 87%vs96%,P vs80%,P = 0.05). Concerning adverse events, there were no significant differences. In multivariate analyses, attemptedEMR, lesion size and depressed type were independent predictors of conversion toESD. AttemptedUEMRwas an independent predictor of piecemeal resection andRX/R1 resection. Conclusion The present study indicated thatUEMRcould be a feasible endoscopic resection method forSNADET(UMIN000025442).