Clinical efficacy analysis of preoperative endoscopic mucosal resection for non-ampullary lesions of the duodenum

Abstract

Abstract Background: With the continuous development of endoscopic technology, the detection rate of more and more non ampullary duodenal lesions (NADLs) in the duodenum is gradually increasing. Therefore, it was crucial to choose appropriate endoscopic techniques for the treatment of non ampullary lesions of the duodenum, this article aims to explore the selection of endoscopic treatment methods for lesions, in order to further improve its efficacy and safety, and improve the quality of life of patients. Method and Results: A retrospective analysis was conducted on the clinical data of 100 patients diagnosed with non ampullary duodenal lesions in the Li Huili East Hospital and Yinzhou Second Hospital of Ningbo Medical Center from May 2015 to May 2023.All patients successfully completed endoscopic resection with a total resection rate of 100.0% and an overall R0 resection rate of 96.0%,for further research, we conducted a detailed analysis of lesions with a size of 10-20mm, including 55 patients, including 22 in the EMR group, 15 in the Pre-cut-EMR group, and 18 in the ESD group, the study showed that the surgery time in the EMR and Pre-cut-EMR groups was shorter than that in the ESD group, but the R0 resection rate in the EMR group was lower than that in the Pre-cut-EMR and ESD groups, the average length of hospital stay and average hospital expenses in the EMR group and Pre-cut-EMR group were significantly lower than those in the ESD group, and the difference was statistically significant (P<0.05). Conclusion: The R0 resection rate of EMR in lesions with a size of 10-20mm was relatively low, making it impossible to completely resect at once, resulting in a high probability of intraoperative residual and high postoperative risk; Pre-cut-EMR, as a new technology, had a higher R0 resection rate compared to EMR, with ESD, Pre-cut-EMR had lower surgical difficulty, shorter surgical time, higher safety performance, and lower incidence of complications.