Factors Related to Delayed Adverse Events of Endoscopic Submucosal Dissection in the Duodenum

TatsuyaKawamura; TakashiHirose; NaomiKakushimaKazuhiroFurukawaSatoshiFuruneEriIshikawaTsunakiSawadaMaedaKeikoTakeshiYamamuraTakuyaIshikawaEizaburoOhnoMasanaoNakamuraTakashiHondaMasatoshiIshigamiHirokiKawashimaMitsuhiroFujishiro

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Factors Related to Delayed Adverse Events of Endoscopic Submucosal Dissection in the Duodenum

机译：Factors Related to Delayed Adverse Events of Endoscopic Submucosal Dissection in the Duodenum

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Introduction: Endoscopic submucosal dissection for duodenal neoplasms (D-ESD) is considered a technically demanding procedure regarding the high risk of delayed adverse events. Data regarding optimal managements of ulcers after D-ESD are lacking. Methods: A retrospective analysis was performed on consecutive 145 cases of D-ESD for superficial nonampullary duodenal epithelial tumors at a single referral center. Factors related to delayed adverse events and the healing process of ulcers after D-ESD were analyzed. Results: Complete ulcer suture after D-ESD was performed in 128 cases (88). Two delayed perforation occurred among cases with incomplete suture. Delayed bleeding occurred in 8 cases (6) within 3 weeks. The ulcer closure rate at second-look endoscopy (SLE) was significantly low among cases with delayed bleeding (12.5 vs. 75, p = 0.001). The bleeding rate before SLE was significantly high among patients who did not have complete ulcer closure after D-ESD (0.8 vs. 12, p = 0.036). The ratio of lesions located in the second oral-Vater was significantly low among ulcers re-opened at SLE (38 vs. 14, p = 0.044). Proton-pump inhibitors (PPIs) were administered for a median of 7 weeks (range 1–8 weeks). At 3 weeks, active ulcer stages were observed in a few cases, and healing or scarring was observed in most cases. Conclusions: Complete ulcer suture was related to decreased risk of delayed adverse events after D-ESD. From the bleeding period and healing process of D-ESD ulcers, the minimum required length of PPI may be 3 weeks after D-ESD.

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来源
《Digestive diseases》 |2023年第1期|80-88|共9页
作者
TatsuyaKawamura; TakashiHirose; NaomiKakushimaKazuhiroFurukawaSatoshiFuruneEriIshikawaTsunakiSawadaMaedaKeikoTakeshiYamamuraTakuyaIshikawaEizaburoOhnoMasanaoNakamuraTakashiHondaMasatoshiIshigamiHirokiKawashimaMitsuhiroFujishiro;
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作者单位

Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine;

Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan;

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正文语种英语
中图分类消化系及腹部疾病;
关键词
Duodenum; Delayed bleeding; Delayed perforation; Endoscopic submucosal dissection; Second-look endoscopy;

Factors Related to Delayed Adverse Events of Endoscopic Submucosal Dissection in the Duodenum

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