Surgical endoscopy · 2026
Comparative efficacy and safety of hybrid versus conventional endoscopic submucosal dissection for non-ampullary duodenal submucosal tumors.
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Luo Shao-Bin, Wang Li, Zhang Ji-Yuan, Qu Yi-Fan, Li Quan-Lin, Zhou Ping-Hong, Liu Zu-Qiang
Аннотация
BACKGROUND AND AIMS: Hybrid endoscopic submucosal dissection (H-ESD) is established to be curable and safe for colorectal submucosal tumors (SMTs). We aimed to evaluate the feasibility and safety of H-ESD and conventional ESD (C-ESD) for non-ampullary duodenal SMTs (NAD-SMTs).
METHODS: From September 2017 to December 2024, patients with NAD-SMTs treated with H-ESD or C-ESD at the Endoscopy Center of Zhongshan Hospital were retrospectively analyzed. After propensity score matching (PSM), baseline characteristics, clinical outcomes, and follow-up were retrospectively analyzed.
RESULTS: With similar baseline characteristics between the two groups after PSM, the H-ESD group had a shorter procedural duration (41 vs. 67 min, P < 0.001) compared to the C-ESD group. The en bloc resection rates were 93.8 and 92.2%, and the R0 resection rates were 90.6 and 89.1%, respectively. Although there was no statistically significant difference, the H-ESD group had a lower overall adverse event (AE) rate. The H-ESD group had 1 case of abdominal effusion and 1 case of febrile episode, whereas the C-ESD group had 2 cases of intraprocedural bleeding, 1 case of intraoperative muscle layer injury, 1 case of pneumoperitoneum, 1 case of delayed bleeding, and 1 case of abdominal effusion. During the median follow-up period, no recurrence occurred in the H-ESD group, while one local recurrence was detected in the C-ESD group.
CONCLUSIONS: Both H-ESD and C-ESD were safe and effective for NAD-SMTs; however, H-ESD resulted in a reduced procedure time without increasing the occurrence of AEs compared with C-ESD. Therefore, H-ESD may be recommended as a treatment for NAD-SMTs.
METHODS: From September 2017 to December 2024, patients with NAD-SMTs treated with H-ESD or C-ESD at the Endoscopy Center of Zhongshan Hospital were retrospectively analyzed. After propensity score matching (PSM), baseline characteristics, clinical outcomes, and follow-up were retrospectively analyzed.
RESULTS: With similar baseline characteristics between the two groups after PSM, the H-ESD group had a shorter procedural duration (41 vs. 67 min, P < 0.001) compared to the C-ESD group. The en bloc resection rates were 93.8 and 92.2%, and the R0 resection rates were 90.6 and 89.1%, respectively. Although there was no statistically significant difference, the H-ESD group had a lower overall adverse event (AE) rate. The H-ESD group had 1 case of abdominal effusion and 1 case of febrile episode, whereas the C-ESD group had 2 cases of intraprocedural bleeding, 1 case of intraoperative muscle layer injury, 1 case of pneumoperitoneum, 1 case of delayed bleeding, and 1 case of abdominal effusion. During the median follow-up period, no recurrence occurred in the H-ESD group, while one local recurrence was detected in the C-ESD group.
CONCLUSIONS: Both H-ESD and C-ESD were safe and effective for NAD-SMTs; however, H-ESD resulted in a reduced procedure time without increasing the occurrence of AEs compared with C-ESD. Therefore, H-ESD may be recommended as a treatment for NAD-SMTs.