ID | 62756 |
フルテキストURL | |
著者 |
Kanzaki, Hiromitsu
Department of Gastroenterology and Hepatology, Okayama University Hospital
ORCID
publons
researchmap
Matsueda, Kazuhiro
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital
Nakagawa, Masahiro
Department of Endoscopy, Hiroshima City Hiroshima Citizens Hospital
Inaba, Tomoki
Department of Gastroenterology, Kagawa Prefectural Central Hospital
Takatani, Masahiro
Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital
Takenaka, Ryuta
Department of Internal Medicine, Tsuyama Chuo Hospital
Yoshioka, Masao
Department of Internal Medicine, Okayama Saiseikai General Hospital
Imagawa, Atsushi
Department of Gastroenterology, Mitoyo General Hospital
Inoue, Masafumi
Department of Gastroenterology, Japanese Red Cross Okayama Hospital
Suzuki, Seiyuu
Department of Internal Medicine, Sumitomo Besshi Hospital
Tomoda, Jun
Department of Internal Medicine, Akaiwa Medical Association Hospital
Iwamuro, Masaya
Department of Gastroenterology and Hepatology, Okayama University Hospital
ORCID
Kaken ID
publons
researchmap
Kawano, Seiji
Department of Gastroenterology and Hepatology, Okayama University Hospital
ORCID
Kawahara, Yoshiro
Department of Gastroenterology, Japanese Red Cross Okayama Hospital
Tanaka, Takehiro
Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
ORCID
Kaken ID
publons
Okada, Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Hospital
Kaken ID
publons
researchmap
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抄録 | Sporadic non-ampullary duodenal adenoma (SNADA) is a rare disease, and therefore, its clinical characteristics have not been comprehensively investigated. Furthermore, owing to the high complication rates and severity of endoscopic resection, treatment strategies vary among facilities. In the present study, we aimed to clarify the clinical characteristics and course of SNADA. We extracted clinical and histological records of SNADA cases diagnosed in 11 hospitals between September 1999 and August 2014. The patients were divided into "no-resection" and "resection" groups based on the initial treatment approach. We investigated the long-term outcome of the "no-resection" group and treatment results of the "resection" group, with particular interest in endoscopic resection. Overall, 299 patients were diagnosed with SNADA. The median age at diagnosis was 67 years (range, 31-88 years), with approximately twice as many men as women. The median tumor size was 8.0 mm (2-60 mm). In total, 161 patients were initially selected for no-resection and 138 underwent resection. Age >70 years and the presence of either severe illness or poor performance status were significantly related to opting for no-resection. In the no-resection group, 101 patients underwent endoscopic follow-up for at least 1 year. During the observational period (2.5 +/- 2.2 years), 27 lesions (27%) disappeared following cold forceps biopsy, and 13 lesions (14%) presented lateral growth. Four lesions (4%) changed to mucosal carcinoma, 3 were treated endoscopically, and 1 was surgically resected. Nineteen patients died; however, no one died of duodenal carcinoma. In the endoscopic resection group, en bloc resection was achieved in 78% of patients. However, the complication rate for perforation was 7%, and endoscopic submucosal dissection was associated with a 36% perforation rate. With the low incidence of cancer development and no disease specific death, the strategy of initially not performing resection could be considered especially for the older adults, poor-prognosis patients, or small lesions.
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キーワード | duodenal neoplasms
endoscopic mucosal resection
natural history
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発行日 | 2021-10-01
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出版物タイトル |
Medicine
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巻 | 100巻
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号 | 39号
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出版者 | Lippincott Williams & Wilkins
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開始ページ | e27382
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ISSN | 0025-7974
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © 2021 the Author(s).
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論文のバージョン | publisher
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PubMed ID | |
DOI | |
Web of Science KeyUT | |
関連URL | isVersionOf https://doi.org/10.1097/MD.0000000000027382
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ライセンス | http://creativecommons.org/licenses/by-nc/4.0
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Citation | Kanzaki H, Matsueda K, Nakagawa M, Inaba T, Takatani M, Takenaka R, Yoshioka M, Imagawa A, Inoue M, Suzuki S, Tomoda J, Iwamuro M, Kawano S, Kawahara Y, Tanaka T, Okada H. Clinical characteristics and course of sporadic non-ampullary duodenal adenomas: a multicenter retrospective study. Medicine 2021;100:39(e27382).
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