The conundrum in endoscopic management of duodenal polyps: a tertiary cancer center experience.


Journal

Expert review of gastroenterology & hepatology
ISSN: 1747-4132
Titre abrégé: Expert Rev Gastroenterol Hepatol
Pays: England
ID NLM: 101278199

Informations de publication

Date de publication:
Jun 2022
Historique:
pubmed: 11 6 2022
medline: 7 7 2022
entrez: 10 6 2022
Statut: ppublish

Résumé

Endoscopic mucosal resection of duodenal polyps (EMR) is a challenging intervention. The aim of this study was to review the patient characteristics, techniques, procedure outcomes, adverse events, and recurrence of duodenal polyps. Patients were included if they had pathologically confirmed non-ampullary duodenal polyps and had received EMR with at least one follow-up EGD for surveillance. Descriptive statistics were employed to report the findings. A total of 65 patients underwent a total of 90 EMRs for duodenal polyps. The mean age was 65.4 years, and 29 of the patients were female. Complete resection of the visible mass was achieved in 96.9% of cases. Endoscopic hemostasis was required in 18.5% of patients. Delayed bleeding occurred in 9%, and delayed perforations requiring surgical intervention occurred in 2.2% of patients with no mortality. Surgery after EMR was needed in 12.7% of cases. Eleven (16.9%) patients had recurrent duodenal adenoma on follow-up EGD. Duodenal polyps can be safely resected and have a notable recurrence rate. This is particularly true for adenomas, warranting post-resection endoscopic surveillance. The appropriate interval for post-resection surveillance of duodenal adenomas should be a focus of future study.

Sections du résumé

BACKGROUND UNASSIGNED
Endoscopic mucosal resection of duodenal polyps (EMR) is a challenging intervention. The aim of this study was to review the patient characteristics, techniques, procedure outcomes, adverse events, and recurrence of duodenal polyps.
RESEARCH DESIGN AND METHODS UNASSIGNED
Patients were included if they had pathologically confirmed non-ampullary duodenal polyps and had received EMR with at least one follow-up EGD for surveillance. Descriptive statistics were employed to report the findings.
RESULTS UNASSIGNED
A total of 65 patients underwent a total of 90 EMRs for duodenal polyps. The mean age was 65.4 years, and 29 of the patients were female. Complete resection of the visible mass was achieved in 96.9% of cases. Endoscopic hemostasis was required in 18.5% of patients. Delayed bleeding occurred in 9%, and delayed perforations requiring surgical intervention occurred in 2.2% of patients with no mortality. Surgery after EMR was needed in 12.7% of cases. Eleven (16.9%) patients had recurrent duodenal adenoma on follow-up EGD.
CONCLUSION UNASSIGNED
Duodenal polyps can be safely resected and have a notable recurrence rate. This is particularly true for adenomas, warranting post-resection endoscopic surveillance. The appropriate interval for post-resection surveillance of duodenal adenomas should be a focus of future study.

Identifiants

pubmed: 35687675
doi: 10.1080/17474124.2022.2088508
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

569-576

Auteurs

Jeffrey H Lee (JH)

Department of Gastroenterology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Abraham C Yu (AC)

Department of Gastroenterology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Faisal S Ali (FS)

Department of Gastroenterology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Osman Ahmed (O)

Department of Gastroenterology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Patrick Lynch (P)

Department of Gastroenterology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Phillip Ge (P)

Department of Gastroenterology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Emmanuel Coronel (E)

Department of Gastroenterology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Michael Kim (M)

Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Martin Coronel (M)

Department of Gastroenterology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Justin Folloder (J)

Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, Texas, USA.

Matthew H G Katz (MHG)

Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, Texas, USA.

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