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Ippei Tanaka,Dai Hirasawa,Hiroaki Saito,Junichi Akahira,Tomoki Matsuda 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.6
Background/Aims: Endoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal tumors (SNADETs) is associat-ed with a high rate of en bloc resection. However, the technique for ESD remains challenging. Recent studies have demonstrated the ef-fectiveness of S-O clips in colonic and gastric ESD. We evaluated the efficacy and safety of duodenal ESD using an S-O clip for SNA-DETs. Methods: Consecutive patients who underwent ESD for SNADETs between January 2011 and December 2021 were retrospectively en-rolled. Propensity score matching analysis was used to compare patients who underwent duodenal ESD with the S-O clip (S-O group)and those who underwent conventional ESD (control group). Intraoperative perforation rate was the primary outcome, while proce-dure time and R0 resection rate were the secondary outcomes. Results: After propensity score matching, 16 pairs were created: 43 and 17 in the S-O and control groups, respectively. The intraopera-tive perforation rate in the S-O group was significantly lower than that in the control group (p=0.033). A significant difference was ob-served in the procedure time between the S-O and control groups (39±9 vs. 82±30 minutes, respectively; p=0.003). Conclusions: The S-O clip reduced the intraoperative perforation rate and procedure time, which may be useful and effective in duo-denal ESD.