Postoperative Wundinfektionen

Abstract

Introduction: Data on endoscopic resection of sporadic duodenal adenoma (SDA) are sparse; wepresent our results concerning safety and effi− cacy in a retrospective analysis of saline−assisted endoscopic resection of SDA. Patients and methods: The cases of all patients who underwent endoscopic resection for SDA be− tween May 1998 and May 2006 were analyzed. Endoscopic resection was carried out using standard injection and cut methods. In some pa− tients hemoclips and argon plasma coagulation were used, either for prophylaxis or for the treat− ment of procedure−related bleeding. Results: Thirty−six patients with a total of 37 le− sions (mean size 19mm, range 4?50mm) were analyzed. Lesions larger than 20mm were more frequently resected piecemeal (P = 0.022). Intra− procedural bleeding occurred in 14% of cases, without any significant association with lesion size or the resection technique. One fatal perforation occurred. Macroscopically complete resec− tion was achieved in 97% of cases, as confirmed by at least one negative control endoscopy with biopsies after a mean follow−up of 15 months. Al− though clipping and argon plasma coagulation were not applied in any systematic way, it was noticeable that in the 20 cases in which they were used for hemostasis or prevention, no de− layed bleeding was observed after the proce− dures. In contrast, bleeding occurred in 22% of the 23 procedures performed without these ad− ditional techniques. Conclusion: Endoscopic resection is an efficient and acceptably safe technique for treating SDA. Further studies need to assess whether systema− tic bleeding prophylaxis will reduce the inci− dence of delayed hemorrhage after endoscopic resection.