Usefulness of the S-O clip for duodenal endoscopic submucosal dissection: a propensity score-matched study
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Background/Aims: Endoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal tumors (SNADETs) is associat-ed with a high rate of en bloc resection. However, the technique for ESD remains challenging. Recent studies have demonstrated the ef-fectiveness of S-O clips in colonic and gastric ESD. We evaluated the efficacy and safety of duodenal ESD using an S-O clip for SNA-DETs. Methods: Consecutive patients who underwent ESD for SNADETs between January 2011 and December 2021 were retrospectively en-rolled. Propensity score matching analysis was used to compare patients who underwent duodenal ESD with the S-O clip (S-O group)and those who underwent conventional ESD (control group). Intraoperative perforation rate was the primary outcome, while proce-dure time and R0 resection rate were the secondary outcomes. Results: After propensity score matching, 16 pairs were created: 43 and 17 in the S-O and control groups, respectively. The intraopera-tive perforation rate in the S-O group was significantly lower than that in the control group (p=0.033). A significant difference was ob-served in the procedure time between the S-O and control groups (39±9 vs. 82±30 minutes, respectively; p=0.003). Conclusions: The S-O clip reduced the intraoperative perforation rate and procedure time, which may be useful and effective in duo-denal ESD.
Abstract
Background/Aims: Endoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal tumors (SNADETs) is associat-ed with a high rate of en bloc resection. However, the technique for ESD remains challenging. Recent studies have demonstrated the ef-fectiveness of S-O clips in colonic and gastric ESD. We evaluated the efficacy and safety of duodenal ESD using an S-O clip for SNA-DETs. Methods: Consecutive patients who underwent ESD for SNADETs between January 2011 and December 2021 were retrospectively en-rolled. Propensity score matching analysis was used to compare patients who underwent duodenal ESD with the S-O clip (S-O group)and those who underwent conventional ESD (control group). Intraoperative perforation rate was the primary outcome, while proce-dure time and R0 resection rate were the secondary outcomes. Results: After propensity score matching, 16 pairs were created: 43 and 17 in the S-O and control groups, respectively. The intraopera-tive perforation rate in the S-O group was significantly lower than that in the control group (p=0.033). A significant difference was ob-served in the procedure time between the S-O and control groups (39±9 vs. 82±30 minutes, respectively; p=0.003). Conclusions: The S-O clip reduced the intraoperative perforation rate and procedure time, which may be useful and effective in duo-denal ESD.
참고문헌 (21)
- Goda K, "Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors in Japan : multicenter case series", Dig Endosc, 26(Suppl 2), pp.23~29 (2014)
- Tsuji S, "Preoperative endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors, including magnifying endoscopy", World J Gastroenterol, 21, pp.11832~11841 (2015)
- Kakushima N, "Method and timing of resection of superficial non-ampullary duodenal epithelial tumors", Dig Endosc, 26(Suppl 2), pp.35~40 (2014)
- Kato M, "Predictors of technical difficulty with duodenal ESD", Endosc Int Open, 7, pp.E1755~ (2019)
- Jung JH, "Endoscopic submucosal dissection for sessile, nonampullary duodenal adenomas", Endoscopy, 45, pp.133~135 (2013)
- Matsumoto S, "Endoscopic submucosal dissection for duodenal tumors : a single-center experience", Endoscopy, 45, pp.136~137 (2013)
- Hoteya S, "Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma", adenoma of the duodenum : feasibility and long-term outcomes, 2013, pp.1, 2~7
- Ritsuno H, "Prospective clinical trial of traction device-assisted endoscopic submucosal dissection of large superficial colorectal tumors using the S-O clip", Surg Endosc, 28, pp.3143~3149 (2014)
- Hashimoto R, "Usefulness of the S-O clip for gastric endoscopic submucosal dissection(with video)", Surg Endosc, 32, pp.908~914 (2018)
- Hashimoto R, "Duodenal endoscopic submucosal dissection with traction method using the S-O clip", Dig Endosc, 29, pp.635~ (2017)
- 이보인, "Routine Mucosal Closure with a Detachable Snare and Clips after Endoscopic Submucosal Dissection for Gastric Epithelial Neoplasms: A Randomized Controlled Trial", Gut and Liver, 5(4), pp.454~459 (2011), 거트앤리버 소화기연관학회협의회
- Takimoto K, "Endoscopic tissue shielding method with polyglycolic acid sheets and fibrin glue to prevent delayed perforation after duodenal endoscopic submucosal dissection", Dig Endosc, 26(Suppl 2), pp.46~49 (2014)
- Hoteya S, "Delayed bleeding after endoscopic submucosal dissection for non-ampullary superficial duodenal neoplasias might be prevented by prophylactic endoscopic closure : analysis of risk factors", Dig Endosc, 27, pp.323~330 (2015)
- Kinoshita S, "Accuracy of biopsy for the preoperative diagnosis of superficial nonampullary duodenal adenocarcinoma", Gastrointest Endosc, 86, pp.329~332 (2017)
- Inoue T, "Delayed perforation : a hazardous complication of endoscopic resection for non-ampullary duodenal neoplasm", Dig Endosc, 26, pp.220~227 (2014)
- Basford PJ, "Endoscopic resection of sporadic duodenal adenomas : comparison of endoscopic mucosal resection(EMR)with hybrid endoscopic submucosal dissection(ESD)techniques and the risks of late delayed bleeding", Surg Endosc, 28, pp.1594~1600 (2014)
- Seo JY, "Usefulness and safety of endoscopic treatment for nonampullary duodenal adenoma and adenocarcinoma", J Gastroenterol Hepatol, 29, pp.1692~1698 (2014)
- Ono H, "Clinical issues of duodenal EMR", ESD, 2011, pp.46, 1669~1677
- Tashima T, "Effectiveness of clip-and-thread traction-assisted duodenal endoscopic submucosal dissection : a propensity score-matched study(with video)", Gastrointest Endosc, 95, pp.918~928 (2022)
- Nabi Z, "Outcomes of endoscopic submucosal dissection in duodenal neuroendocrine tumors", J Gastrointest Surg, 26, pp.275~277 (2022)
- Dohi O, "Efficacy and safety of endoscopic submucosal dissection using a scissors-type knife with prophylactic over-the-scope clip closure for superficial non-ampullary duodenal epithelial tumors", Dig Endosc, 32, pp.904~913 (2020)