scholarly journals Retroflexion in the duodenal bulb combined with tunnel and double-clip traction: the key to successful endoscopic submucosal dissection of a malignant gastric adenoma protruding through the pylorus

Endoscopy ◽  
2021 ◽  
Author(s):  
Marion Schaefer ◽  
Thomas Lambin ◽  
Benjamin Hamel ◽  
Clémentine Gandilhon ◽  
Jérémie Jacques ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Duodenal Bulb ◽  
Gastric Adenoma ◽  
Submucosal Dissection

scholarly journals Small neuroendocrine tumor of the duodenal bulb: Endoscopic submucosal dissection, laparoscopic and endoscopic cooperative surgery or surgery?

2016 ◽  
Vol 07 (01) ◽  
pp. 024-026
Author(s):  
Nikolaos V. Chrysanthos ◽  
Evagelia Anagnostopoulou ◽  
Eleni Triga ◽  
Stratigoula Sakelariou ◽  
Pinelopi Korkolopoulou
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Endoscopic Submucosal Dissection ◽  
Duodenal Bulb ◽  
Neuroendocrine Neoplasms ◽  
Ki 67 ◽  
Node Metastasis ◽  
Submucosal Dissection ◽  
Endoscopic Control ◽  
Limited Surgery

AbstractNeuroendocrine neoplasms of the gastric tube are less common than adenocarcinomas. Topography includes stomach, small intestine, Vater ampulla, and gross intestine. They are graded as neuroendocrine tumors grade I and II (NETs GI and GII) and neuroendocrine carcinomas GIII based on Ki-67 index and mitotic count.[1] Endoscopic treatment for GI NETs ≤1 cm that does not extend beyond the submucosal layer and does not demonstrate lymph node metastasis is recommended. Tumors ≥2 cm, with lymph node metastasis, are indicated for surgical treatment. The treatment strategy for tumors between 10 and 20 mm in size remains controversial.[2] We present a rare case of a 60-year-old male patient with end-stage renal failure who underwent a screening pretransplantation endoscopic control. Colonoscopy had no pathological findings. Gastroscopy reveals an abnormal mucosa in the anterior upper part of the duodenal bulb that was described as a micronodular mucosa and a central nodule of 6 mm with erythematous mucosa. Histology of the micronodular mucosa reveals a heterotopic gastric mucosa and a small hyperplastic polyp. Biopsies from the nodule reveal a carcinoid tumor (NET GI). Immunohistochemistry: Positive chromogranin levels, low mitotic index (1/10 HPF), and Ki-67 index <1% [Figure 2]. Gastrin levels were normal and chromogranin levels were abnormal (314 ng/ml, ULN <120 ng/ml). Spiral tomography of the thorax and the abdomen were normal. Endoscopic submucosal dissection is indicated for small NETs (≤1 cm). Laparoscopic and endoscopic cooperative surgery is a novel method, but the experience is limited. Surgery is the best choice for large NETs (>2 cm) and those of the duodenal bulb with histological extensions and the lack of assessing depth invasion.

scholarly journals Predictive Significance of Serum IL-6, VEGF, and CRP in Gastric Adenoma and Mucosal Carcinoma before Endoscopic Submucosal Dissection

2009 ◽  
Vol 54 (2) ◽  
pp. 99 ◽  
Author(s):  
Jin Seok Jang ◽  
Seok Reyol Choi ◽  
Sang Young Han ◽  
Myung Hwan Roh ◽  
Jong Hoon Lee ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Gastric Adenoma ◽  
Submucosal Dissection ◽  
Mucosal Carcinoma
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