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Endoscopic papillec...
Endoscopic papillectomy for ampullary lesions in patients with familial adenomatous polyposis compared with sporadic lesions: A propensity score-matched cohort
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- Vu Trung, K. (författare)
- Division of Gastroenterology, Medical Department II, University of Leipzig Medical Center, Leipzig, Germany
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- Regner, S. (författare)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups,Department of Digestive Surgery, Centre Hospitalier Universitaire de Montpellier, Montpellier, France,Department of Clinical Sciences Malmö, Section for Surgery, Lund University, Lund, Sweden
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- Hollenbach, Marcus (författare)
- Division of Gastroenterology, Medical Department II, University of Leipzig Medical Center, Leipzig, Germany
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- Caillol, Fabrice (författare)
- Department of Endoscopy, Institut Paoli Calmettes, Marseille, France
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- Paik, Woo H. (författare)
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
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- Napoleon, Bertrand (författare)
- Hopital prive Jean Mermoz, Ramsay Generale de Sante, Lyon, France
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- Masaryk, Viliam (författare)
- Department of Gastroenterology, Hepatology, Diabetes and General Internal Medicine, SRH Wald-Klinikum Gera, Gera, Germany
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- van der Wiel, Sophia E. (författare)
- Department of Gastroenterology and Hepatology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
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- Pérez-Cuadrado-Robles, Enrique (författare)
- Interventional Endoscopy, Hôpital Européen Georges-Pompidou, Department of Gastroenterology, Georges-Pompidou European Hospital, Paris, France; Department of Gastroenterology, Bruxelles, Cliniques universitaires Saint-Luc, Belgium
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- Musquer, Nicolas (författare)
- Saint Herblain, France
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- Halimi, Asif (författare)
- Umeå universitet,Kirurgi,Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden
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- Soares, Kevin (författare)
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, NY, United States
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- Petrone, Maria C. (författare)
- Endosonography Unit, Pancreato-Biliary Endoscopy and Endosonography Division, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
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- Crippa, Stefano (författare)
- Department of Pancreatic Surgery, Vita Salute San Raffaele University, Milan, Italy
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- Kleemann, Tobias (författare)
- Department of Gastroenterology and Rheumatology, Carl-Thiem-Klinikum Cottbus, Cottbus, Germany
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- Albers, David (författare)
- Department of Medicine and Gastroenterology, Essen, Germany
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- Weismüller, Tobias J. (författare)
- Department of Internal Medicine - Gastroenterology and Oncology, Vivantes Humboldt Hospital, Berlin, Germany; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
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- Dugic, Ana (författare)
- Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden; Department of Gastroenterology, Friedrich-Alexander-University Erlangen-Nuremberg, Medical Campus Oberfranken, Bayreuth, Germany
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- Meier, Benjamin (författare)
- Department of Medicine, Gastroenterology, Hematology, Oncology, Pneumology, Diabetes and Infectious Diseases; RKH Clinic Ludwigsburg, Ludwigsburg, Germany
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- Wedi, Edris (författare)
- Department of Gastroenterology and Gastrointestinal Oncology, University Medicine Göttingen, Göttingen, Germany
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- Schiemer, Moritz (författare)
- Department of Medicine II, University of Freiburg Medical Center, Freiburg, Germany
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- Gaujoux, Sebastien (författare)
- Department of Digestive and HBP Surgery, Groupe Hospitalier Pitié-Salpêtrière APHP, Médecine Sorbonne Université, Paris, France
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(creator_code:org_t)
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- Georg Thieme Verlag KG, 2022
- 2022
- Engelska 10 s.
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Ingår i: Endoscopy. - : Georg Thieme Verlag KG. - 0013-726X .- 1438-8812. ; 55:8, s. 709-718
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background Familial adenomatous polyposis (FAP) is a rare inherited syndrome that predisposes the patient to cancer. Treatment of FAP-related ampullary lesions is challenging and the role of endoscopic papillectomy has not been elucidated. We retrospectively analyzed the outcomes of endoscopic papillectomy in matched cohorts of FAPrelated and sporadic ampullary lesions (SALs). Methods This retrospective multicenter study included 1422 endoscopic papillectomy procedures. Propensity score matching including age, sex, comorbidity, histologic subtype, and size was performed. Main outcomes were complete resection (R0), technical success, complications, and recurrence. Results Propensity score matching identified 202 patients (101 FAP, 101 SAL) with comparable baseline characteristics. FAP patients were mainly asymptomatic (79.2% [95 %CI 71.2-87.3] vs. 46.5% [95 %CI 36.6-56.4]); P < 0.001). The initial R0 rate was significantly lower in FAP patients (63.4% [95%CI 53.8-72.9] vs. 83.2% [95%CI 75.8-90.6]; P = 0.001). After repeated interventions (mean 1.30 per patient), R0 was comparable (FAP 93.1% [95%CI 88.0-98.1] vs. SAL 97.0% [95%CI 93.7-100]; P = 0.19). Adverse events occurred in 28.7%. Pancreatitis and bleeding were the most common adverse events in both groups. Severe adverse events were rare (3.5 %). Overall, 21 FAP patients (20.8% [95%CI 12.7-28.8]) and 16 SAL patients (15.8% [95%CI 8.6-23.1]; P = 0.36) had recurrence. Recurrences occurred later in FAP patients (25 [95 %CI 18.3-31.7] vs. 2 [95 %CI CI 0.06-3.9] months). Conclusions Endoscopic papillectomy was safe and effective in FAP-related ampullary lesions. Criteria for endoscopic resection of ampullary lesions can be extended to FAP patients. FAP patients have a lifetime risk of relapse even after complete resection, and require long-time surveillance. © 2022 Georg Thieme Verlag. All rights reserved.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Adenomatous Polyposis Coli
- Ampulla of Vater
- Common Bile Duct Neoplasms
- Humans
- Neoplasm Recurrence, Local
- Propensity Score
- Retrospective Studies
- Treatment Outcome
- ablation therapy
- adult
- adverse event
- aged
- American Society of Anaesthesiologists score
- ampullectomy
- Article
- bile duct dilatation
- cardiovascular disease
- cholangitis
- clinical feature
- clinical outcome
- cohort analysis
- comorbidity
- conscious sedation
- controlled study
- disease free survival
- duodenum injury
- en bloc resection
- endoscopic papillotomy
- endoscopic retrograde cholangiopancreatography
- endoscopic surgery
- familial adenomatous polyposis
- female
- follow up
- general anesthesia
- histology
- human
- human tissue
- laboratory test
- length of stay
- lifetime risk
- major clinical study
- male
- overall survival
- pancreaticoduodenectomy
- pancreatitis
- perforation
- postoperative complication
- postoperative hemorrhage
- propensity score
- radiofrequency ablation
- recurrent disease
- retrospective study
- sporadic ampullary lesion
- Vater papilla tumor
- ampulla of Vater
- bile duct tumor
- clinical trial
- colon polyposis
- multicenter study
- pathology
- treatment outcome
- tumor recurrence
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Vu Trung, K.
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Regner, S.
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Hollenbach, Marc ...
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Caillol, Fabrice
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Paik, Woo H.
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Napoleon, Bertra ...
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Masaryk, Viliam
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van der Wiel, So ...
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Pérez-Cuadrado-R ...
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Musquer, Nicolas
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Halimi, Asif
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Soares, Kevin
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Petrone, Maria C ...
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Crippa, Stefano
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Kleemann, Tobias
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Albers, David
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Weismüller, Tobi ...
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Dugic, Ana
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Meier, Benjamin
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Wedi, Edris
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Schiemer, Moritz
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Gaujoux, Sebasti ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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Endoscopy
- Av lärosätet
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Lunds universitet
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Umeå universitet
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Karolinska Institutet