Clinical Endoscopy

Original Article

Endoscopic Suturing for the Prevention and Treatment of Complications Associated with Endoscopic Mucosal Resection of Large Duodenal Adenomas: Jaeil Chung, Kelly Wang, Alexander Podboy, Srinivas Gaddam, Simon K. Lo; Clin Endosc 2022;55(1):95-100. Published online March 3, 2021; DOI: https://doi.org/10.5946/ce.2020.281

Background
/Aims: Endoscopic mucosal resection (EMR) is the primary treatment for duodenal adenomas; however, it is associated with a high risk of perforation and bleeding, especially with larger lesions. The goal of this study was to demonstrate the feasibility and safety of endoscopic suturing (ES) for the closure of mucosal defects after duodenal EMR.
Methods
Consecutive adult patients who underwent ES of large mucosal defects after EMR of large (>2 cm) duodenal adenomas were retrospectively enrolled. The OverStitch ES system was employed for closing mucosal defects after EMR. Clinical outcomes and complications, including delayed bleeding and perforation, were documented.
Results
During the study period, ES of mucosal defects was performed in seven patients in eight sessions (six for prophylaxis and two for the treatment of perforation). All ES sessions were technically successful. No early or delayed post-EMR bleeding was recorded. In addition, no clinically obvious duodenal stricture or recurrence was encountered on endoscopic follow-up evaluation, and no patients required subsequent surgical intervention.
Conclusions
ES for the prevention and treatment of duodenal perforation after EMR is technically feasible, safe, and effective. ES should be considered an option for preventing or treating perforations associated with EMR of large duodenal adenomas.

Citations

Citations to this article as recorded by

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가족성 선종성 용종증 수술 후 발생한 유건종과 십이지장 선종 1 예 ( Desmoid Tumor and Duodenal Adenoma in a Patient with Familial Adenomatous Polyposis : A Case Report ): Korean J Gastrointest Endosc 2001;23(1):32-35. Published online November 30, 2000

Abstract PDF: Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited disorder due to germline mutation of the tumor suppressor adenomatous polyposis coli (APC) gene, Multiple large bowel polyps usually develop in adolescenoe or early adulthood with inevitable progression to colorectal carcinoma. It is well known that patients with FAP are at considerable risk of developing extracolonic manisfestations of the disease. Particularly, desmoid tunors of the abdominal cavity, and duodenal adenomas and carcinomas are the most serious ones. Desmoid tumors and duodenal carcinomas are major muses of death in those patients in whom a prophylactic (procto) colectomy has been performed. We report the case of a 38-yeaz-old man with desmoid tumor and duodenal adenoma developing after total colectomy with ileostomy due fo FAP, and 1iferafures were reviewed. (Korean J Gastroietest Endosc 2001;23:32-35)

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