Background and Aim

Endoscopic resection is recommended for small duodenal neuroendocrine tumors DNETs. However, there is limited data on the outcomes of endoscopic submucosal dissection (ESD) in DNETs. In this study, we aimed to evaluate the outcomes of ESD in DNETs.

Methods

Data of consecutive patients who underwent ESD for DNETs from January 2018 to December 2019 were analyzed, retrospectively. All the cases of ESD were performed with or without traction using rubber band and two endoclips. En-bloc resection, complete endoscopic resection (C-ER), complete pathological resection (C-PR), adverse events, and recurrence were evaluated.

Results

Twenty patients (19 males, 57.50 ± 9.32 years) underwent ESD for DNETs. DNETs measured ≤ 10 mm (7), 10–15 mm (12), and > 15 mm (1). ESD was performed with and without traction in 10 cases each. Mean operating time was 61 ± 17.38 min. En-bloc resection, C-ER, and C-PR were recorded in 90%, 95%, and 75%, respectively. Vertical margins were positive in five patients. Adverse events included perforations in 4 (20%) cases and major bleeding in one case. There was no recurrence at a mean follow-up of 17.20 ± 7.37 months.

Conclusion

ESD is feasible and effective for the management of DNETs. However, caution is advised due to a high risk of adverse events and pathologically incomplete resection.

中文翻译：

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十二指肠神经内分泌肿瘤内镜黏膜下剥离术的结果

背景和目标

对于小的十二指肠神经内分泌肿瘤 DNET，建议进行内镜切除术。然而，关于 DNET 中内窥镜黏膜下剥离术 (ESD) 结果的数据有限。在本研究中，我们旨在评估 DNET 中 ESD 的结果。

方法

回顾性分析了 2018 年 1 月至 2019 年 12 月接受 ESD 治疗 DNET 的连续患者的数据。所有ESD病例均使用橡皮筋和两个内夹进行牵引或不牵引。评估整块切除、完全内镜切除（C-ER）、完全病理切除（C-PR）、不良事件和复发。

结果

20 名患者（19 名男性，57.50 ± 9.32 岁）接受了 DNET 的 ESD。测得的 DNET ≤ 10 mm (7)、10–15 mm (12) 和 > 15 mm (1)。ESD 在牵引和不牵引各 ​​10 例中进行。平均手术时间为 61 ± 17.38 分钟。整块切除、C-ER 和 C-PR 分别记录为 90%、95% 和 75%。5 名患者的垂直切缘呈阳性。不良事件包括 4 例（20%）穿孔和 1 例大出血。平均随访 17.20 ± 7.37 个月没有复发。

结论

ESD 对 DNET 的管理是可行和有效的。然而，由于不良事件的高风险和病理学不完全切除，建议谨慎。