Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(06): E712-E718
DOI: 10.1055/a-1793-9439
Original article

Prospective multicenter study of the efficacy and safety of cold forceps polypectomy for ≤ 6-mm non-ampullary duodenal low-grade adenomas

Autoren

  • Hiromitsu Kanzaki

     1   Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
  • Joichiro Horii

     2   Department of Gastroenterology, Fukuyama Medical Center, Hiroshima, Japan
  • Ryuta Takenaka

     3   Department of Internal Medicine, Tsuyama Central Hospital, Okayama, Japan
  • Hiroyuki Nakagawa

     4   Department of Endoscopy, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
  • Kazuhiro Matsueda

     5   Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Okayama, Japan
  • Takao Tsuzuki

     6   Department of Internal Medicine, Himeji Red Cross Hospital, Hyogo, Japan
  • Masahide Kita

     7   Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
  • Yasushi Yamasaki

     1   Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
  • Takehiro Tanaka

     8   Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
  • Masaya Iwamuro

     1   Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
  • Seiji Kawano

     1   Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
  • Yoshiro Kawahara

     9   Department of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
  • Jun Tomoda

    10   Department of Internal Medicine, Akaiwa Medical Association Hospital, Okayama, Japan
  • Hiroyuki Okada

     1   Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
TRIAL REGISTRATION: Multi-Center, Single arm, prospective trial at https://upload.umin.ac.jp

Abstract

Background and study aims Because the endoscopic treatment for non-ampullary duodenal adenoma (NADA) has a non-negligible risk of adverse events (AEs), a safe and easy treatment for NADA is desirable. This was a multicenter prospective trial evaluating the efficacy and safety of cold forceps polypectomy (CFP) for diminutive NADAs.

Patients and methods This study was prospectively conducted at six general hospitals and one university hospital. The inclusion criteria were histologic and endoscopic diagnosis of low-grade NADA measuring ≤ 6 mm. A second endoscopy was scheduled for 1 month after CFP. After confirmation of the success of CFP, 6-month and 12-month surveillance endoscopies were scheduled. The primary endpoint was the endoscopic and histologic disease disappearance rates at the 12-month endoscopy.

Results Thirty-nine lesions from 38 patients were prospectively included. Median tumor size at enrollment was 5 mm (range 3–6 mm). There were four cases of remnant lesions at the second endoscopy, and the lesion disappearance rate of single CFP was 89.7 % (35 /39; 95 % confidence interval (CI), 76.9 %–97.9 %). In three cases, complete removal of the lesion was achieved with a single re-CFP, but one case required four repeat CFPs. The lesion disappearance rate at 12-month endoscopy was 97.4 % (38 /39; 95 %CI, 86.8 %–99.5 %). During the follow-up period, no AEs related to CFP were observed.

Conclusions CFP for NADA ≤ 6 mm was safe and effective in this study. This common endoscopic method to remove lesions may be an option for treatment of diminutive NADAs.



Publikationsverlauf

Eingereicht: 01. September 2021

Angenommen nach Revision: 20. Dezember 2021

Artikel online veröffentlicht:
10. Juni 2022

© 2022. 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/)

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