D-LECS Shows Promise Over endoscopic resection with Fewer Complications, Finds Study

The study revealed the following findings:

• Two patients in the D-LECS group required conversion to open surgery to avoid potential injury to the ampulla of Vater.
• The overall operation time was significantly longer for the D-LECS group.
• Endoscopy time was similar between the D-LECS and ER groups.
• The length of postoperative hospital stay was comparable in both groups.
• The ER group had a significantly higher rate of moderate-to-severe complications (Clavien–Dindo grade II or higher) compared to the D-LECS group.
• Piecemeal resections and positive resection margins were observed in both groups, with no significant difference.
• One patient in each group experienced tumor recurrence.
• In the D-LECS group, one patient with positive resection margins who refused additional surgery later died of duodenal cancer.

The findings highlight the potential benefits of D-LECS in managing duodenal tumors, especially in terms of safety and procedural outcomes. However, the authors emphasize the importance of individualized evaluation to determine whether D-LECS is suitable for each patient, as factors such as tumor location and risk of complications must be considered.

"Overall, the study supports D-LECS as an effective alternative to ER, offering improved safety without compromising oncological outcomes, and highlights the need for further research to refine patient selection criteria," the authors concluded.

Reference:

Shindo, K., Ohuchida, K., Nagasue, T., Ogino, H., Horioka, K., Moriyama, T., Nagayoshi, K., Mizuuchi, Y., Ikenaga, N., Nakata, K., Oda, Y., & Nakamura, M. (2024). Efficacy of Laparoscopic and Endoscopic Cooperative Surgery Compared to Endoscopic Resection for Duodenal Tumor Treatment. Asian Journal of Endoscopic Surgery, 18(1), e70130. https://doi.org/10.1111/ases.70130