Evidence map›Paper›PMID 40745240›Full record

ArticleDigestive diseases and sciences2025

Outcomes and Limitations of Duodenal Endoscopic Submucosal Dissection in the United States.

Mai A Khalaf, Fares Ayoub, Tara Keihanian, Allan Zhang, Christina Zelt, Salmaan Jawaid, Neil Sharma, Mohamed O Othman

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Is Duodenal ESD Ready for Take-Off in the USA?Digestive diseases and sciences · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mai A KhalafGastroenterology Section at Baylor St Luke's Medical Center, William T. Butler Endowed Chair for Distinguished Faculty, Gastroenterology and Hepatology Section Baylor College of Medicine, 7200 Cambridge Street, Suite 8C, Houston, TX, 77030, USA.
Fares AyoubGastroenterology Section at Baylor St Luke's Medical Center, William T. Butler Endowed Chair for Distinguished Faculty, Gastroenterology and Hepatology Section Baylor College of Medicine, 7200 Cambridge Street, Suite 8C, Houston, TX, 77030, USA.
Tara KeihanianGastroenterology Section at Baylor St Luke's Medical Center, William T. Butler Endowed Chair for Distinguished Faculty, Gastroenterology and Hepatology Section Baylor College of Medicine, 7200 Cambridge Street, Suite 8C, Houston, TX, 77030, USA.
Allan ZhangSchool of Medicine, Baylor College of Medicine, Houston, TX, USA.
Christina ZeltParkview Cancer Institute, Fort Wayne, IN, USA.
Salmaan JawaidGastroenterology Section at Baylor St Luke's Medical Center, William T. Butler Endowed Chair for Distinguished Faculty, Gastroenterology and Hepatology Section Baylor College of Medicine, 7200 Cambridge Street, Suite 8C, Houston, TX, 77030, USA.
Neil SharmaParkview Cancer Institute, Fort Wayne, IN, USA.
Mohamed O OthmanGastroenterology Section at Baylor St Luke's Medical Center, William T. Butler Endowed Chair for Distinguished Faculty, Gastroenterology and Hepatology Section Baylor College of Medicine, 7200 Cambridge Street, Suite 8C, Houston, TX, 77030, USA. mohamed.othman@bcm.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsEndoscopic submucosal dissection (ESD) of duodenal tumors is challenging due to its unique anatomy and high risk of adverse events. Its use is limited in the United States due to procedural complexity. Our study highlights the feasibility of ESD for managing duodenal tumors in the US.

methodsThis retrospective cohort included duodenal ESD lesions at two tertiary US medical centers from 2017 to 2024. The primary outcomes included technical success, en bloc, R0, and curative resection rates. Secondary outcomes were adverse events and recurrence rates.

resultsSeventy-four duodenal lesions in 70 patients were resected by three endoscopists with variable levels of experience in ESD. Most lesions (56%) were located in the duodenal bulb. Technical success was 100%, with en bloc and R0 resection rates of 78.3% and 51.4%, respectively. Mean procedure time was 85.9 ± 50.4 min. Neuroendocrine tumors had higher en bloc (90% vs. 62.5%) but lower R0 resection rates (43.8% vs. 53.1%) than adenomas. Adenomas had more positive lateral margins (50% vs. 18.3%). Larger lesions (> 30 mm) had lower en bloc resection rates than smaller ones (≤ 30 mm). The overall adverse event rate was 25.7%. Intraprocedural deep muscle injury and bleeding were more common in lesions > 3 cm (18.2% and 6%) than in smaller lesions (7.3% and 2.4%).

conclusionsDuodenal ESD has lower en-bloc and R0 resection rates, but higher risk of adverse events compared to other sites. An individualized approach and careful discussion of endoscopic versus non-endoscopic options with every patient is warranted.

Indexed as

AdenomaDuodenal NeoplasmsDuodenoscopyEndoscopic Mucosal ResectionNeuroendocrine TumorsAgedAged, 80 and overDuodenumFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeUnited StatesDuodenal adenomaDuodenal tumorsEndoscopic submucosal dissectionNeuroendocrine tumorsSmall intestine tumors

Identifiers

PMID40745240

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.