PMID- 34993587 OWN - NLM STAT- MEDLINE DCOM- 20220603 LR - 20221020 IS - 1432-2218 (Electronic) IS - 0930-2794 (Linking) VI - 36 IP - 7 DP - 2022 Jul TI - Sporadic non-ampullary duodenal adenomas: efficacy and outcomes of endoscopic resection. PG - 5224-5231 LID - 10.1007/s00464-021-08900-5 [doi] AB - BACKGROUND AND AIMS: Sporadic non-ampullary duodenal adenomas (SNDAs) are often referred to tertiary centers because of the challenges in endoscopic resection. There is a paucity of data on both technical and clinical outcomes. The aim of our study was to evaluate the efficacy and safety of endoscopic resection for the treatment of SNDA in two western centers. METHODS: This is a retrospective study reporting data of a cohort of patients referred for resection of SNDA between 2013 and 2017. Patients with familial adenomatous polyposis or ampullary lesions were excluded from present analysis. Outcomes considered for this study were technical success, adverse events, recurrence and need for surgery. RESULTS: 120 patients (mean age 66 +/- 11.9 years, 64male) were enrolled in the study. Mean size of the lesions was 23.3 mm (range 5-80). Fifty-six en-bloc endoscopic mucosal resection (EMR) (46.6%), 41 piecemeal EMR (pEMR) and 23 endoscopic submucosal dissection were performed. Intra-procedural perforation was observed in 4 patients (3.3%). Fourteen post-procedural (11.6%) adverse events were recorded. All post-procedural perforations occurred in lesions > 30 mm. Recurrence was observed in 11 patients (9.5%) during a mean follow-up of 29 months. All recurrences were successfully managed endoscopically. 119 patients were still alive at last follow-up. CONCLUSION: Endoscopic resection can be successfully carried out in majority of patients. Size > 30 mm seems to be the predictor of high adverse events risk. CI - (c) 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Maselli, Roberta AU - Maselli R AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. FAU - Alkandari, Asma A AU - Alkandari AA AD - Department of Gastroenterology, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK. FAU - Spadaccini, Marco AU - Spadaccini M AUID- ORCID: 0000-0003-3909-9012 AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. marco.spadaccini@humanitas.it. AD - Department of Biomedical Sciences, Humanitas University, Rozzano, MI, Italy. marco.spadaccini@humanitas.it. AD - Digestive Endoscopy Unit, Humanitas University, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy. marco.spadaccini@humanitas.it. FAU - Belletrutti, Paul AU - Belletrutti P AD - Department of Biomedical Sciences, Humanitas University, Rozzano, MI, Italy. FAU - Craviotto, Vincenzo AU - Craviotto V AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. AD - Department of Biomedical Sciences, Humanitas University, Rozzano, MI, Italy. FAU - Galtieri, Piera Alessia AU - Galtieri PA AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. FAU - Anderloni, Andrea AU - Anderloni A AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. FAU - Fugazza, Alessandro AU - Fugazza A AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. FAU - Carrara, Silvia AU - Carrara S AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. FAU - Di Leo, Milena AU - Di Leo M AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. AD - Department of Biomedical Sciences, Humanitas University, Rozzano, MI, Italy. FAU - Pellegatta, Gaia AU - Pellegatta G AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. FAU - Gabbiadini, Roberto AU - Gabbiadini R AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. AD - Department of Biomedical Sciences, Humanitas University, Rozzano, MI, Italy. FAU - Colombo, Matteo AU - Colombo M AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. AD - Department of Biomedical Sciences, Humanitas University, Rozzano, MI, Italy. FAU - Capogreco, Antonio AU - Capogreco A AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. AD - Department of Biomedical Sciences, Humanitas University, Rozzano, MI, Italy. FAU - Bhandari, Pradeep AU - Bhandari P AD - Department of Gastroenterology, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK. FAU - Repici, Alessandro AU - Repici A AD - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, MI, Italy. AD - Department of Biomedical Sciences, Humanitas University, Rozzano, MI, Italy. LA - eng PT - Journal Article DEP - 20220107 PL - Germany TA - Surg Endosc JT - Surgical endoscopy JID - 8806653 SB - IM MH - *Adenoma/pathology/surgery MH - Aged MH - *Duodenal Neoplasms/pathology/surgery MH - Duodenum/pathology MH - *Endoscopic Mucosal Resection MH - Humans MH - Middle Aged MH - Neoplasm Recurrence, Local/epidemiology MH - Retrospective Studies MH - Treatment Outcome OTO - NOTNLM OT - Adverse event OT - Duodenum OT - Endoscopic resection OT - Endoscopy OT - Sporadic non-ampullary duodenal adenomas EDAT- 2022/01/08 06:00 MHDA- 2022/06/07 06:00 CRDT- 2022/01/07 06:37 PHST- 2021/03/22 00:00 [received] PHST- 2021/11/21 00:00 [accepted] PHST- 2022/01/08 06:00 [pubmed] PHST- 2022/06/07 06:00 [medline] PHST- 2022/01/07 06:37 [entrez] AID - 10.1007/s00464-021-08900-5 [pii] AID - 10.1007/s00464-021-08900-5 [doi] PST - ppublish SO - Surg Endosc. 2022 Jul;36(7):5224-5231. doi: 10.1007/s00464-021-08900-5. Epub 2022 Jan 7.