TY - JOUR
T1 - 表在性十二指腸上皮性腫瘍に対する内視鏡的切除後有害事象の臨床経過およびマネジメント：多施設共同後方視的研究
AU - Dohi, Osamu
AU - Kato, Motohiko
AU - Takeuchi, Yoji
AU - Hoteya, Shu
AU - Oyama, Tsuneo
AU - Nonaka, Satoru
AU - Yoshimizu, Shoichi
AU - Yoshida, Masao
AU - Ohata, Ken
AU - Miura, Yoshimasa
AU - Hara, Yuko
AU - Tsuji, Shigetsugu
AU - Yamasaki, Yasushi
AU - Ueyama, Hiroya
AU - Kurahara, Koichi
AU - Tashima, Tomoaki
AU - Abe, Nobutsugu
AU - Nakayama, Atsushi
AU - Oda, Ichiro
AU - Yahagi, Naohisa
N1 - Publisher Copyright:
© 2025 Japan Gastroenterological Endoscopy Society. All rights reserved.
PY - 2025/1
Y1 - 2025/1
N2 - Objectives: This study aimed to elucidate the clinical course and management of adverse events (AEs) after endoscopic resection (ER) for superficial duodenal epithelial tumors (SDETs). Methods: Consecutive patients who underwent ER of SDETs between January 2008 and July 2018 at 18 Japanese institutions were retrospectively enrolled. The study outcomes included the clinical course, management, and risk of surgical conversion with perioperative AEs after ER for SDETs. Results: Of the 226 patients with AEs, the surgical conversion rate was 8.0%(18/226), including 3.7% (4/108), 1.0% (1/99), and 50.0% (12/24) of patients with intraoperative perforation, delayed bleeding, or delayed perforation, respectively. In the multivariate logistic analysis, involvement of the major papilla(odds ratio [OR] 12.788; 95% confidence interval [CI] 2.098-77.961, P=0.006) and delayed perforation (OR 37.054; 95% CI 10.219-134.366, P<0.001) were significant risk factors for surgical conversion after AEs. Delayed bleeding occurred from postoperative days 1-14 or more, whereas delayed perforation occurred within 3 days in all cases. Conclusions: The surgical conversion rate was higher for delayed perforation than those for other AEs after ER of SDETs. Involvement of the major papilla and delayed perforation were significant risk factors for surgical conversion following AEs. In addition, reliable prevention of delayed perforation is required for 3 days after duodenal ER to prevent the need for surgical interventions.
AB - Objectives: This study aimed to elucidate the clinical course and management of adverse events (AEs) after endoscopic resection (ER) for superficial duodenal epithelial tumors (SDETs). Methods: Consecutive patients who underwent ER of SDETs between January 2008 and July 2018 at 18 Japanese institutions were retrospectively enrolled. The study outcomes included the clinical course, management, and risk of surgical conversion with perioperative AEs after ER for SDETs. Results: Of the 226 patients with AEs, the surgical conversion rate was 8.0%(18/226), including 3.7% (4/108), 1.0% (1/99), and 50.0% (12/24) of patients with intraoperative perforation, delayed bleeding, or delayed perforation, respectively. In the multivariate logistic analysis, involvement of the major papilla(odds ratio [OR] 12.788; 95% confidence interval [CI] 2.098-77.961, P=0.006) and delayed perforation (OR 37.054; 95% CI 10.219-134.366, P<0.001) were significant risk factors for surgical conversion after AEs. Delayed bleeding occurred from postoperative days 1-14 or more, whereas delayed perforation occurred within 3 days in all cases. Conclusions: The surgical conversion rate was higher for delayed perforation than those for other AEs after ER of SDETs. Involvement of the major papilla and delayed perforation were significant risk factors for surgical conversion following AEs. In addition, reliable prevention of delayed perforation is required for 3 days after duodenal ER to prevent the need for surgical interventions.
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U2 - 10.11280/gee.67.70
DO - 10.11280/gee.67.70
M3 - Article
AN - SCOPUS:85216991421
SN - 0387-1207
VL - 67
SP - 70
EP - 82
JO - GASTROENTEROLOGICAL ENDOSCOPY
JF - GASTROENTEROLOGICAL ENDOSCOPY
IS - 1
ER -