Comparison Between endoscopic submucosal dissection and laparoscopic endoscopic cooperative surgery for non-ampullary duodenal neuroendocrine tumors: a single-center retrospective cohort study.

backgroundNeuroendocrine tumors (NETs) are relatively rare in the duodenum. We aimed to compare the clinical outcomes of endoscopic submucosal dissection (ESD) and laparoscopic endoscopic cooperative surgery (LECS) for non-ampullary duodenal NETs. MATERIALS AND

methodsThis single-center retrospective study included patients with non-ampullary duodenal NETs treated with ESD or LECS between 2010 and 2024. Data on patient demographics, surgical outcomes, and short- and long-term prognoses were collected.

resultsWe enrolled a total of 29 patients. No significant differences were observed between the ESD and LECS groups with regard to sex, age, height, weight, or tumor location. The median tumor diameter was significantly larger in the LECS group than in the ESD group (12.00 mm vs. 5.00 mm). The tumors in the LECS group were located deeper (submucosa or muscularis propria) than those in the ESD group. Both groups achieved high rates of en bloc resection (100% for ESD and 100% for LECS) and R0 resection (100% for ESD and 93.3% for LECS). There were no significant differences in postoperative complications, such as bleeding, stenosis, or abdominal infection between groups. The median duration of hospitalization was longer in the LECS group than in the ESD group (11.00 vs. 7.00 days). No recurrence or metastasis was observed in either group during follow-up.

conclusionBoth ESD and LECS demonstrated high en bloc resection rates and R0 resection rates, along with favorable short- and long-term prognoses for non-ampullary duodenal NETs. LECS appears to be a safe and effective treatment option with an efficacy comparable to that of ESD and may be suitable for larger or deeply infiltrating lesions, potentially helping avoid the need for more invasive surgical procedures.