CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(08): E1214-E1221
DOI: 10.1055/a-1487-5594
Review

Comparison of endoscopic resection techniques for duodenal neuroendocrine tumors: systematic review

Helcio Pedrosa Brito
1  Department of Endoscopy, Hospital 9 de Julho, São Paulo, São Paulo, Brazil
,
Isabela Trindade Torres
1  Department of Endoscopy, Hospital 9 de Julho, São Paulo, São Paulo, Brazil
,
Karine Corcione Turke
2  Department of Surgery, ABC Medical School, Santo André, São Paulo, Brazil
,
Artur Adolfo Parada
1  Department of Endoscopy, Hospital 9 de Julho, São Paulo, São Paulo, Brazil
,
Jaques Waisberg
2  Department of Surgery, ABC Medical School, Santo André, São Paulo, Brazil
3  Department of Surgery, Hospital do Servidor Público Estadual, São Paulo, São Paulo, Brazil
,
Ricardo Vieira Botelho
3  Department of Surgery, Hospital do Servidor Público Estadual, São Paulo, São Paulo, Brazil
› Author Affiliations

Abstract

Background and study aims Regardless of size, duodenal neuroendocrine tumors (dNETs) should be considered potentially malignant. A complete resection without complications is essential to increase safety procedures. The aim of this review was to describe effectiveness and possible complications of endoscopic techniques resection for resectioning dNETs in patients with tumors ≤ 20 mm in diameter.

Methods An electronic bibliographic search was conducted using MEDLINE (via PubMed), Embase, Cochrane Central, and Google Scholar virtual databases. The types of intervention were endoscopic mucosal resection alone (EMR) or with cap (EMR-C), with a ligation device (EMR-L), with previous elevation of the tumor (EMR-I) or with endoscopic submucosal dissection (ESD); argon plasm coagulation (APC), and polypectomy. The outcome measures adopted were presence of free margin associated with tumor resection, tumor recurrence, complications (bleeding and perforation), and length of the procedure.

Results Ten publications were included with the result of 224 dNET resections. EMR alone and polypectomy resulted in the most significantly compromised margin. The most frequent complication was bleeding (n = 21), followed by perforation (n = 8). Recurrence occurred in 13 cases, the majority of those under EMR or EMR-I.

Conclusions EMR-C or EMR-I should be preferred for resectioning of dNETs. Polypectomy should not be indicated for resection of dNETs due to the high occurrence of incomplete resections. EMR alone must be avoided due a higher frequency of compromised margin and recurrent surgery. ESD was associated with no recurrence, however, but an increased occurrence of bleeding and perforation.



Publication History

Received: 14 September 2020

Accepted: 29 March 2021

Publication Date:
16 July 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany