Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video)
Background/Aims. Underwater endoscopic mucosal resection (UEMR) has recently attracted attention as a safe and effective method for superficial nonampullary duodenal epithelial tumors (SNADETs). However, water is a fluid and it does not remain in all areas, and because it mixes easily with other sub...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2022/2040792 |
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| author | Takeshi Yamashina Masaaki Shimatani Yu Takahashi Masahiro Takeo Natsuko Saito Hironao Matsumoto Takeshi Kasai Masataka Kano Kimi Sumimoto Toshiyuki Mitsuyama Hiroyuki Marusawa Akiyoshi Nishio Takafumi Yuba Toshihito Seki Makoto Naganuma |
| author_facet | Takeshi Yamashina Masaaki Shimatani Yu Takahashi Masahiro Takeo Natsuko Saito Hironao Matsumoto Takeshi Kasai Masataka Kano Kimi Sumimoto Toshiyuki Mitsuyama Hiroyuki Marusawa Akiyoshi Nishio Takafumi Yuba Toshihito Seki Makoto Naganuma |
| author_sort | Takeshi Yamashina |
| collection | DOAJ |
| description | Background/Aims. Underwater endoscopic mucosal resection (UEMR) has recently attracted attention as a safe and effective method for superficial nonampullary duodenal epithelial tumors (SNADETs). However, water is a fluid and it does not remain in all areas, and because it mixes easily with other substances, it sometimes becomes cloudy and reduces visibility. A new endoscopic gel product that does not mix with fluids and tends to remain in the injected area has recently been applied to EMR and is known as gel immersion EMR (GIEMR) or under-gel EMR. Here, we evaluated the endoscopic outcomes of UEMR and GIEMR. Materials and Methods. This was a retrospective cohort study conducted in two municipal hospitals. We identified 24 patients with SNADETs of 3–18 mm in diameter who underwent UEMR or GIEMR. One lesion was excluded from the analysis because it was found to be in the stomach after surgery. The primary outcome was procedure time. Results. GIEMR significantly reduced the procedure time compared with UEMR (5 min vs. 10 min, P=0.016). There was no significant difference between the UEMR and GIEMR groups for en bloc resection rate (93% vs. 100%, P=1.0) and R0 resection rate (57% vs. 80%, P=0.39). No serious complications were observed in either group. Conclusions. GIEMR of SNADET has the potential to reduce procedure time compared with UEMR and may be particularly effective in areas where immersion in water is difficult. |
| format | Article |
| id | doaj-art-d9b32501a54c476d95a5a55020bfa571 |
| institution | Kabale University |
| issn | 1687-630X |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-d9b32501a54c476d95a5a55020bfa5712025-02-03T05:49:58ZengWileyGastroenterology Research and Practice1687-630X2022-01-01202210.1155/2022/2040792Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video)Takeshi Yamashina0Masaaki Shimatani1Yu Takahashi2Masahiro Takeo3Natsuko Saito4Hironao Matsumoto5Takeshi Kasai6Masataka Kano7Kimi Sumimoto8Toshiyuki Mitsuyama9Hiroyuki Marusawa10Akiyoshi Nishio11Takafumi Yuba12Toshihito Seki13Makoto Naganuma14Division of Gastroenterology and HepatologyDivision of Gastroenterology and HepatologyThe Third Department of Internal MedicineDivision of Gastroenterology and HepatologyDivision of Gastroenterology and HepatologyDivision of Gastroenterology and HepatologyDivision of Gastroenterology and HepatologyDivision of Gastroenterology and HepatologyDivision of Gastroenterology and HepatologyDivision of Gastroenterology and HepatologyDepartment of Gastroenterology and HepatologyDivision of Gastroenterology and HepatologyDivision of Gastroenterology and HepatologyDivision of Liver Disease CenterThe Third Department of Internal MedicineBackground/Aims. Underwater endoscopic mucosal resection (UEMR) has recently attracted attention as a safe and effective method for superficial nonampullary duodenal epithelial tumors (SNADETs). However, water is a fluid and it does not remain in all areas, and because it mixes easily with other substances, it sometimes becomes cloudy and reduces visibility. A new endoscopic gel product that does not mix with fluids and tends to remain in the injected area has recently been applied to EMR and is known as gel immersion EMR (GIEMR) or under-gel EMR. Here, we evaluated the endoscopic outcomes of UEMR and GIEMR. Materials and Methods. This was a retrospective cohort study conducted in two municipal hospitals. We identified 24 patients with SNADETs of 3–18 mm in diameter who underwent UEMR or GIEMR. One lesion was excluded from the analysis because it was found to be in the stomach after surgery. The primary outcome was procedure time. Results. GIEMR significantly reduced the procedure time compared with UEMR (5 min vs. 10 min, P=0.016). There was no significant difference between the UEMR and GIEMR groups for en bloc resection rate (93% vs. 100%, P=1.0) and R0 resection rate (57% vs. 80%, P=0.39). No serious complications were observed in either group. Conclusions. GIEMR of SNADET has the potential to reduce procedure time compared with UEMR and may be particularly effective in areas where immersion in water is difficult.http://dx.doi.org/10.1155/2022/2040792 |
| spellingShingle | Takeshi Yamashina Masaaki Shimatani Yu Takahashi Masahiro Takeo Natsuko Saito Hironao Matsumoto Takeshi Kasai Masataka Kano Kimi Sumimoto Toshiyuki Mitsuyama Hiroyuki Marusawa Akiyoshi Nishio Takafumi Yuba Toshihito Seki Makoto Naganuma Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video) Gastroenterology Research and Practice |
| title | Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video) |
| title_full | Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video) |
| title_fullStr | Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video) |
| title_full_unstemmed | Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video) |
| title_short | Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video) |
| title_sort | gel immersion endoscopic mucosal resection emr for superficial nonampullary duodenal epithelial tumors may reduce procedure time compared with underwater emr with video |
| url | http://dx.doi.org/10.1155/2022/2040792 |
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