内镜下乳头切除术对早期十二指肠壶腹癌患者有益吗?

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2023-11-28 DOI:10.1002/jhbp.1398

Ko Suzuki, Yusuke Kurita, Kensuke Kubota, Yuji Fujita, Seitaro Tsujino, Yuji Koyama, Shintaro Tsujikawa, Shigeki Tamura, Shin Yagi, Sho Hasegawa, Takamitsu Sato, Kunihiro Hosono, Noritoshi Kobayashi, Hiromichi Iwashita, Shoji Yamanaka, Satoshi Fujii, Itaru Endo, Atsushi Nakajima

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引用次数: 0

摘要

背景/目的:目前对于早期十二指肠壶腹腺癌的内镜下乳头切除术(EP)的应用尚无共识。本研究旨在探讨早期十二指肠壶腹腺癌患者应用EP的可行性。方法:对壶腹腺癌行EP的患者进行分析。评估全切率和临床全切率。临床完全切除定义为完全切除或切除边缘阳性或未知，但手术切除标本中无癌，或至少1年随访后内窥镜检查未复发。结果:腺癌30例(原位癌[Tis]: 21例，粘膜肿瘤[T1a(M)]: 4例，Oddi括约肌肿瘤[T1a(OD)]: 5例)，全切除率为60.0% (18/30)(Tis: 66.7% [14/21]， T1a[M]: 50.0% [2/4]， T1a[OD]: 40.0%[2/5])。平均随访46.8个月。所有患者复发率6.7%(2/30)。腺癌临床完全切除率为89.2% (25/28);Tis、T1a(M)和T1a(OD)的检出率分别为89.4%(17/19)、100%(4/4)和80%(4/5)。结论:EP有可能实现早期(Tis和T1a)十二指肠壶腹腺癌的临床完全切除。

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Endoscopic papillectomy could be rewarding to patients with early stage duodenal ampullary carcinoma?

Background/Purpose

There is currently no consensus on the use of endoscopic papillectomy (EP) for early stage duodenal ampullary adenocarcinoma. This study aimed to evaluate the feasibility of EP for patients with early stage duodenal ampullary adenocarcinoma.

Methods

Patients who underwent EP for ampullary adenocarcinomas were investigated. Complete and clinical complete resection rates were evaluated. Clinical complete resection was defined as either complete resection or resection with positive or unknown margins but no cancer in the surgically resected specimen, or no recurrence on endoscopy after at least a 1-year follow-up.

Results

Adenocarcinoma developed in 30 patients (carcinoma in situ [Tis]: 21, mucosal tumors [T1a(M)]: 4, tumors in the sphincter of Oddi [T1a(OD)]: 5). The complete resection rate was 60.0% (18/30) (Tis: 66.7% [14/21], T1a[M]: 50.0% [2/4], and T1a[OD]: 40.0% [2/5]). The mean follow-up period was 46.8 months. The recurrence rate for all patients was 6.7% (2/30). The clinical complete resection rates of adenocarcinoma were 89.2% (25/28); rates for Tis, T1a(M), and T1a(OD) were 89.4% (17/19), 100% (4/4), and 80% (4/5), respectively.