Endoscopic tissue shielding with polyglycolic acid sheets, fibrin glue and clips to prevent delayed perforation after duodenal endoscopic resection

Doyama, Hisashi; Tominaga, Kei; Yoshida, Naohiro; Takemura, Kenichi; Yamada, Shinya

doi:10.1111/den.12253

Cited by 47 publications

(50 citation statements)

References 24 publications

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“…Previous studies have demonstrated that if the perforation is in the course of the surgery, the hole maybe closed using an endoscopic titanium clip or sutured using anylon snare, followed by the administration of antibiotics and fasting for several days (8,(34)(35)(36)(37). Abdominal computed tomography may be performed in all patients with perforation to identify whether the retroperitoneal perforation has occurred.…”

Section: Discussionmentioning

confidence: 99%

“…All patients are recommended to be administered a PPI for ≥2 months following ESD, and undergo follow-up endoscopic examinations 2 and 6 months following ESD, and subsequently every 12 months. In addition, abdominal computed tomography or ultrasonography may be performed annually to identify lymph node and distant metastases, if the final pathological diagnosis of the specimen revealed characteristics of malignancy (8,(34)(35)(36)(37).…”

Section: Discussionmentioning

confidence: 99%

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An early superficial non-ampullary duodenal tumor cured with endoscopic submucosal dissection: A case report

Lin

Yang

et al. 2017

Oncology Letters

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Abstract. Early superficial non-ampullary duodenal tumors are particularly rare, the clinical manifestations, including typical endoscopic or imaging features, and treatment methods are not well-characterized. The present case report describes a case of an asymptomatic 74-year-old male who presented to the Taizhou People's Hospital (Taizhou, China) for a regular health screening, where a primary superficial non-ampullary duodenal tumor was identified. Upper endoscopy revealed ~1.2 cm lesion in the second portion of the duodenum. Chromoscopy and magnification endoscopy indicated an early cancer characteristic. Subsequent endoscopic submucosal dissection was performed to remove the lesion. Histopathology validated that the lesion was a high-grade intro-epithelial neoplasm without lymph node or blood vessel invasion. IntroductionSuperficial non-ampullary duodenal tumor (SNADT), adenoma or carcinoma, is a rare type of gastrointestinal tract epithelial tumor and can be defined as a lesion limited to the mucosa, and/or submucosa which is not arising from the papilla of Vater (1,2). Typically, the likelihood of developing duodenal adenoma in patients with familial adenomatous polyposis (FAP) is high and this type of adenoma may progress to carcinoma (3). In contrast, sporadic NADT may develop de novo or through the adenoma-carcinoma pathway, as observed in patients with FAP (4). The prognosis of patients with advanced stage carcinoma is poor (5). However, if the duodenal tumor is diagnosed at an early stage and the patient undergoes complete resection, using an endoscopic method, the patient may experience a markedly improved outcome. Therefore, early detection and treatment of lesions are required (6).As the incidence of sporadic SNADT is rare, endoscopic markers suggestive of early stage SNADT have not been established. In addition, although endoscopic approaches, including endoscopic mucosa resection (EMR) and endoscopic submucosal dissection (ESD), are minimally invasive, and localized treatments in comparison to conventional surgery, there are a number of high risk complications (including bleeding and perforation) which may occur during the endoscopic resection (ER) (7-9). Therefore, the relatively rare incidence, and the presence of a thin duodenal wall and rich vascularity make it difficult to detect and treat SNADT lesions.The present case report describes an elderly patient presented to the Taizhou People's Hospital (Taizhou, China) for esophagogastroduodenoscopy and was identified to exhibit a superficial lesion (~1.2 cm) in the second portion of the duodenum. Chromoscopy and magnification endoscopy with narrow band imaging (ME-NBI) indicated an early stage lesion. Subsequently, ESD was performed to remove the lesion. Histopathology validated the high-grade intro-epithelial tumor diagnosis with negative margins, and without lymph or blood vessel involvement. Case reportIn the present case report, a 70-year-old Chinese male presented to the Taizhou People's Hospital (Taizhou, China) for a regular health scree...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An early superficial non-ampullary duodenal tumor cured with endoscopic submucosal dissection: A case report

Lin

Yang

et al. 2017

Oncology Letters

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“…A PGA sheet and fibrin glue have firm adherence characteristics over the long term and become naturally absorbed within about 15 weeks, thus are applicable for various situations and have been shown to be safe 3-5. However, according to the manufacturer’s information, various complications may occur because of characteristics of the fibrin glue, especially anaphylactic reactions, while there is also potential risk for transmission of infectious agents.…”

Section: Discussionmentioning

confidence: 99%

Successful Endoscopic Management of Non-Healing Perforated Duodenal Ulcer with Polyglycolic Acid Sheet and Fibrin Glue

Mishiro

Shibagaki

Matsuda

et al. 2016

ACG Case Reports Journal

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“…This method, considered to be useful, simple and safe, can sometimes present problems because of gravitational influence, with early slipping of the sheets. To resolve this and to improve the coverage, adding clips to PGA-FG has been successfully assessed in endoscopic resection of duodenal lesions, with a median covering procedure time of 22 min[9,10]. …”

Section: Clinical Experiencementioning

confidence: 99%

Endoscopic shielding technique, a new method in therapeutic endoscopy

Bon

Bartolı́

Lorenzo-Zúñiga

2017

WJG

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Prevention of late complications after large endoscopic resection is inefficient with current methods. Endoscopic shielding, as a simple and safe technique, has been proposed to improve the incidence of these events. Different methods, sheets or hydrogels, have showed proven efficacy in the prevention of late bleeding and perforation, as well as the improvement of tissue repair, in experimental models and in clinical practice.

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Endoscopic tissue shielding with polyglycolic acid sheets, fibrin glue and clips to prevent delayed perforation after duodenal endoscopic resection

Cited by 47 publications

References 24 publications

An early superficial non-ampullary duodenal tumor cured with endoscopic submucosal dissection: A case report

An early superficial non-ampullary duodenal tumor cured with endoscopic submucosal dissection: A case report

Successful Endoscopic Management of Non-Healing Perforated Duodenal Ulcer with Polyglycolic Acid Sheet and Fibrin Glue

Endoscopic shielding technique, a new method in therapeutic endoscopy

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