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

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Bernardo Manuel De Sousa Pinto

    Autor

Participantes de fora da FMUP

  • Morais R.
  • Amorim J.
  • Medas R.
  • Santos-Antunes J.
  • Legros R.
  • Albouys J.
  • Moll F.
  • Marques M.
  • Vilas-Boas F.
  • Rodrigues-Pinto E.
  • Gullo I.
  • Carneiro F.
  • Soares E.G.
  • Amaro P.
  • Mesquita P.
  • Rodrigues J.
  • Andrisani G.
  • Sferrazza S.
  • Archer S.
  • Kuttner-Magalhães R.
  • Manzano F.
  • de Santiago E.R.
  • Rimondi A.
  • Murino A.
  • Despott E.
  • Pioche M.
  • Jacques J.
  • Macedo G.

Unidades de investigação

Abstract

Background & Aims: Conventional endoscopic mucosal resection (C-EMR) is established as the primary treatment modality for superficial nonampullary duodenal epithelial tumors (SNADETs), but recently underwater endoscopic mucosal resection (U-EMR) has emerged as a potential alternative. The majority of previous studies focused on Asian populations and small lesions (=20 mm). We aimed to compare the efficacy and outcomes of U-EMR vs C-EMR for SNADETs in a Western setting. Methods: This was a retrospective multinational study from 10 European centers that performed both C-EMR and U-EMR between January 2013 and July 2023. The main outcomes were the technical success, procedure-related adverse events (AEs), and the residual/recurrent adenoma (RRA) rate, evaluated on a per-lesion basis. We assessed the association between the type of endoscopic mucosal resection and the occurrence of AEs or RRAs using mixed-effects logistic regression models (propensity scores). Sensitivity analyses were performed for lesions =20 mm or >20 mm. Results: A total of 290 SNADETs submitted to endoscopic resection during the study period met the inclusion criteria and were analyzed (C-EMR: n = 201, 69.3%; U-EMR: n = 89, 30.7%). The overall technical success rate was 95.5% and comparable between groups. In logistic regression models, compared with U-EMR, C-EMR was associated with a significantly higher frequency of overall delayed AEs (odds ratio [OR], 4.95; 95% CI, 2.87–8.53), postprocedural bleeding (OR, 7.92; 95% CI, 3.95–15.89), and RRAs (OR, 3.66; 95% CI, 2.49–5.37). Sensitivity analyses confirmed these results when solely considering either small (=20 mm) or large (>20 mm) lesions. Conclusions: Compared with C-EMR, U-EMR was associated with a lower rate of overall AEs and RRAs, regardless of lesion size. Our results confirm the possible role of U-EMR as an effective and safe technique in the management of SNADETs. © 2024 AGA Institute

Dados da publicação

ISSN/ISSNe:
1542-7714, 1542-3565

Clinical Gastroenterology and Hepatology  W.B. Saunders Ltd

Tipo:
Article
Páginas:
79-884
PubMed:
38782173
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 1

Citações Recebidas na Scopus: 1

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Keywords

  • Conventional Endoscopic Mucosal Resection; Endoscopic Resection; Superficial Nonampullary Duodenal Epithelial Tumors; Underwater Endoscopic Mucosal Resection

Campos de Estudo

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Investigador Principal: Bernardo Manuel De Sousa Pinto

Estudo Clínico Académico (SARS-CoV-2) . 2021

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