Underwater versus conventional endoscopic mucosal resection for superficial non-ampullary duodenal epithelial tumors ≤20mm: A systematic review and meta-analysis

Lv, Xiu-He; Luo, Rong; Lu, Qing; Deng, Kai; Yang, Jin-Lin

doi:10.1016/j.dld.2022.09.001

Cited by 6 publications

(9 citation statements)

References 27 publications

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“…9 A meta-analysis also showed that UEMR could achieve a higher en bloc resection rate and shorter procedure time compared to cEMR. 17 Perforation rarely occurred during or after the procedure. [9][10][11][12][13][14][15][16][17] In this study, no significant differences existed in any treatment outcome between the cEMR and UEMR groups.…”

Section: Discussionmentioning

confidence: 99%

“…17 Perforation rarely occurred during or after the procedure. [9][10][11][12][13][14][15][16][17] In this study, no significant differences existed in any treatment outcome between the cEMR and UEMR groups. The outcomes of cEMR were sufficiently good in this study, which could explain the lack of differences from those of UEMR.…”

Section: Discussionmentioning

confidence: 99%

“…The results of the comparison between cEMR and UEMR are divided. 9,10,12,15,17 In addition, the risk factors for incomplete resection by UEMR have not been well discussed. Although UEMR is simpler than cEMR, the acceptability and learning curve of UEMR for less-experienced endoscopists are also unclear.…”

Section: Introductionmentioning

confidence: 99%

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Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors?

Tanaka,

Urabe,

Takemoto

et al. 2023

DEN Open

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ObjectivesUnderwater endoscopic mucosal resection (UEMR) is a simpler procedure for superficial non‐ampullary duodenal epithelial tumors (SNADET) than conventional endoscopic mucosal resection (cEMR). This study aimed to evaluate whether cEMR can be substituted by UEMR for SNADET in terms of effectiveness, safety, and learning curve.MethodsA total of 157 consecutive patients with 203 SNADETs ≤20 mm in diameter, including 107 lesions resected by cEMR and 96 lesions resected by UEMR, between January 2019 and May 2023, were retrospectively recruited. The treatment outcomes were compared between the cEMR and UEMR groups. The risk factors for incomplete resection by UEMR were analyzed using univariate and multivariate analyses. Lesions in the UEMR group were divided chronologically into five periods; thereafter, the en bloc resection rate and procedure time were compared.ResultsNo significant differences existed between the cEMR and UEMR groups in the mean procedure time (3.9 min vs. 3.6 min, p = 0.1380) or en bloc resection rate (91% vs. 94%, p = 0.4138). No perforation was observed in either group. Tumor size was an independent risk factor for incomplete resection using UEMR (p < 0.01). The history of biopsy was not associated with incomplete resection using UEMR. The en bloc resection rate of UEMR was 100% (20/20) in the first period and ranged from 90% to 100% over all periods.ConclusionUEMR is safe and effective for SNADET ≤20 mm, regardless of a history of biopsy, and is easy to learn. Thus, UEMR can serve as an alternative to cEMR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors?

Tanaka,

Urabe,

Takemoto

et al. 2023

DEN Open

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“…Because the lumen is desufflated and the mucosa is not expanded, the resection diameter is generally much smaller. In prospective and retrospective studies en bloc resection rates were ∼87% with Uemr [66 ▪ ,67,68,69,70]. A systemic review and meta-analysis by Lv et al that evaluated 635 duodenal adenomas >2 cm reported higher en-bloc resection rates and shorter procedure times with uEMR compared to cEMR [66 ▪ ].…”

Section: Non-ampullary Duodenal Adenomasmentioning

confidence: 99%

“…In prospective and retrospective studies en bloc resection rates were ∼87% with Uemr [66 ▪ ,67,68,69,70]. A systemic review and meta-analysis by Lv et al that evaluated 635 duodenal adenomas >2 cm reported higher en-bloc resection rates and shorter procedure times with uEMR compared to cEMR [66 ▪ ]. On the other hand, another metanalysis by Lee et al [71 ▪ ] that included 2454 lesions found while procedure times were significantly shorter with uEMR, there were no differences in en-bloc resection, bleeding, or perforation rates.…”

Section: Non-ampullary Duodenal Adenomasmentioning

confidence: 99%

Updates in endoscopic management of ampullary and duodenal adenomas

Chadalavada,

Shah

2023

Current Opinion in Gastroenterology

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Purpose of review Adenomas are the most common benign lesions of the gastrointestinal tract. The current review aims to summarize recent literature regarding risk factors, natural history, diagnostic and staging technique, and management strategies for ampullary and nonampullary duodenal adenomas. Recent findings Recent studies identified several possible risks factors for duodenal adenomas (e.g., cholecystectomy, proton pump inhibitor use), although these associations require corroboration. Chromoendoscopy and endocystoscopy may offer accuracy comparable to biopsies in expert hands. Recent publications underscore the reduction in morbidity with endoscopic resection for lesions without signs of malignancy with submucosal invasion. Submucosal injection did not improve safety of endoscopic ampullectomy. Summary Surveillance may be a reasonable strategy for sub-centimeter ampullary adenomas occurring in familial adenomatous polyposis, as they carry a relatively low risk of malignancy. Endoscopic resection is the preferred strategy over surgery in patients without lesions suggestive of invasive malignancy. For nonampullary duodenal adenomas, several endoscopic resection techniques are available, each with their unique advantages and trade-offs. In patients who are not operative candidates but have intraductal extension, endoscopic ablation is an emerging option.

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Underwater Endoscopic Mucosal Resection Vs Conventional Endoscopic Mucosal Resection for Superficial Nonampullary Duodenal Epithelial Tumors in the Western Setting

Morais,

Amorim,

Medas

et al. 2024

Clinical Gastroenterology and Hepatology

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Underwater versus conventional endoscopic mucosal resection for superficial non-ampullary duodenal epithelial tumors ≤20mm: A systematic review and meta-analysis

Cited by 6 publications

References 27 publications

Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors?

Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors?

Updates in endoscopic management of ampullary and duodenal adenomas

Underwater Endoscopic Mucosal Resection Vs Conventional Endoscopic Mucosal Resection for Superficial Nonampullary Duodenal Epithelial Tumors in the Western Setting

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