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Background And Aims: This retrospective study aimed to compare the short- and long-term outcomes of endoscopic submucosal dissection and laparoscopic and endoscopic cooperative surgery in patients with superficial non-ampullary duodenal epithelial tumors.
Patients And Methods: We investigated consecutive patients with SNADETs > 10 mm in size who underwent ESD (ESD group) or LECS (LECS group) between January 2015 and March 2021. The data was used to analyze the clinical course, management, survival status, and recurrence between the two groups.
Results: A total of 113 patients (100 and 13 in the ESD and LECS groups, respectively) were investigated. The rates of en bloc resection and curative resection were 100% vs. 100% and 93.0% vs. 77.0% in the ESD and LECS groups, respectively, with no significant difference. The ESD group had shorter resection and suturing times than the LECS group, but there were no significant difference after propensity score matching. There were also no differences in the rates of postoperative adverse event (7.0% vs. 23.1%; P = 0.161). The 3-year overall survival (OS) rate was high in both the ESD and LECS groups (97.6% vs. 100%; P = 0.334). One patient in the ESD group experienced recurrence due to liver metastasis; however, no deaths related to SNADETs were observed.
Conclusion: ESD and LECS are both acceptable treatments for SNADETs in terms of a high OS rate and a low long-term recurrence rate, thereby achieving a comparable high rate of curative resection. Further studies are necessary to compare the outcomes of ESD and LECS for SNADETs once both techniques are developed further.
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http://dx.doi.org/10.1007/s00464-023-10666-x | DOI Listing |
Front Oncol
August 2025
General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Objective: The comprehensive systematic review was conducted to assess the efficacy and associated factors of submucosal tunnel endoscopic resection (STER) in the treatment of upper gastrointestinal submucosal tumor.
Methods: Databases including PubMed, Web of Science, CNKI, Wang Fang, VIP and Embase were electronically searched for studies on STER for the treatment of upper gastrointestinal submucosal tumors from inception to September 17, 2024. Two authors conducted the literature search independently.
Introduction: Duodenal laparoscopic and endoscopic cooperative surgery (D-LECS) is a promising hybrid approach to managing duodenal neoplasia, including superficial non-ampullary duodenal epithelial tumors (SNADETs) and subepithelial lesions (SELs). This approach aims to reduce adverse events (AEs), such as delayed perforation, often associated with endoscopic submucosal dissection (ESD). Combining laparoscopic techniques for duodenal stabilization with precise endoscopic resection, D-LECS may provide safer and more comprehensive treatment.
View Article and Find Full Text PDFAsian J Endosc Surg
August 2025
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka city, Japan.
Introduction: This study aimed to clarify the safety and feasibility of duodenal laparoscopy-endoscopy cooperative surgery (D-LECS) by comparing the short-term results of D-LECS to those of endoscopic resection (ER) with respect to the rate of some oncological problems.
Methods: This single-center retrospective study included 30 patients with duodenal tumors who underwent ER or D-LECS between March 2013 and March 2023. Fifteen patients underwent D-LECS and 15 underwent ER (EMR, ESD, or hybrid ESD), including two that were observed laparoscopically without any procedure, such as suturing.
Endosc Int Open
April 2025
Medical Research Institute, Kanazawa Medical University, Kahoku-gun, Japan.
Background And Study Aims: Laparoscopic and endoscopic cooperative surgery (LECS) is a beneficial procedure that enables minimal resection of the gastric wall because the tumor can be located endoscopically. However, it is not indicated for epithelial tumors because of risk of peritoneal dissemination. Therefore, we devised a new LECS technique, known as sealed endoscopic full-thickness resection (sealed EFTR), in which the serosa was sealed with a silicone sheet to prevent escape of gastric contents and tumor cells.
View Article and Find Full Text PDFWorld J Gastrointest Oncol
April 2024
The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China.