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| 1 | Clinical outcomes of ampullary neoplasms in resected margin positive or uncertain cases after endoscopic papillectomy显示文摘BACKGROUND Endoscopic papillectomy(EP) for benign ampullary neoplasms could be a lessinvasive alternative to pancreatoduodenectomy(PD). There are some problems and limitations with EP. The post-EP resection margins of ampullary tumors are often positive or uncertain because of the burning effect of EP. The clinical outcomes of resected margin positive or uncertain cases after EP remain unknown.AIM To investigate the clinical outcomes of resected margin positive or uncertain cases after EP.METHODS Between January 2007 and October 2018, all patients with ampullary tumors who underwent EP at Kobe University Hospital were included in this study. The indications for EP were as follows: adenoma, as determined by preoperative endoscopic biopsy, without bile/pancreatic duct extension, according to endoscopic ultrasound or intraductal ultrasound. The clinical outcomes of resected margin positive or uncertain cases after EP were retrospectively investigated.RESULTS Of the 45 patients, 29 were male, and 16 were female. The mean age of the patients was 65 years old. Forty-one patients(89.5%) underwent en bloc resection,and 4 patients(10.5%) underwent piecemeal resection. After EP, 33 tumors were histopathologically diagnosed as adenoma, and 12 were diagnosed as adenocarcinoma. The resected margins were positive or uncertain in 24 patients(53.3%). Of these cases, 15 and 9 were diagnosed as adenoma and adenocarcinoma, respectively. Follow-up observation was selected for all adenomas and 5 adenocarcinomas. In the remaining 4 adenocarcinoma cases,additional PD was performed. Additional PD was performed in 4 cases, and residual carcinoma was found after the additional PD in 1 of these cases. In the follow-up period, local tumor recurrence was detected in 3 cases. Two of these cases involved primary EP-diagnosed adenoma. The recurrent tumors were also adenomas detected by biopsy. The remaining case involved primary EPdiagnosed adenocarcinoma. The recurrent tumor was also an adenocarcinoma.All of the recurrent tumors were successfully treated with argon plasma coagulation(APC). There was no local or lymph node recurrence after the APC.The post-APC follow-up periods lasted for 57.1 to 133.8 mo. No ampullary tumor-related deaths occurred in all patients.CONCLUSION Resected margin positive or uncertain cases after EP could be managed by endoscopic treatment including APC, even in cases of adenocarcinoma. EP could become an effective less-invasive first-line treatment for early stage ampullary tumors. | Arata Sakai Masahiro Tsujimae Atsuhiro Masuda Takao Iemoto Shigeto Ashina Kohei Yamakawa Takeshi Tanaka Shunta Tanaka Yasutaka Yamada Ryota Nakano Yu Sato Manabu Kurosawa Takuya Ikegawa Seiji Fujigaki Takashi Kobayashi Hideyuki Shiomi Yoshifumi Arisaka Tomoo Itoh Yuzo Kodama | 2019 | World Journal of Gastroenterology2019，25，11： | 9 |
| 2 | Diffusion-weighed MR imaging of pancreatic carcinoma显示文摘 | M. Matsuki Y. Inada G. Nakai F. Tatsugami M. Tanikake I. Narabayashi D. Masuda Y. Arisaka K. Takaori N. Tanigawa | 2007 | Abdominal Imaging2007，，4： | 2 |
| 3 | Silk Fibroin of Bombyx moriis Secreted, Assembling a High Molecular Mass Elementary UnitConsisiting of H-chain, L-chain, and P25, with a 6 : 6: 1 MolarRatio 显示文摘 | Inoue S Tanaka K Arisaka F | 2000 | J Biol Chem2000，275，51： | 1 |
| 4 | The utility of the interrupter technique in pediatric asthma显示文摘 | Iimura A Yoshihara S Arisaka O | 2002 | Arerugi2002，51，11： | 1 |
| 5 | Usefulness of suplatast tosilate, a Th2 cytokine inhibitor based on the Thl/Th2 ratio for allergic disease in children: a retrospective study显示文摘 | Yoshihara S Fukuda H Arisaka O | 2011 | Arzneimittelforschung2011，61，7： | 1 |
| 6 | Effect of maxillomandibular advancement o n morphology of velopharyngeal space显示文摘 | Okushi T Tonogi M Arisaka T Kobayashi S Tsukamoto Y Morishita H | | 0，，： | 1 |
| 7 | Proline protects liver from D-galactosamine hepatitis by activating the IL-6/STAT3survival signaling pathway显示文摘 | Obayashi Y Arisaka H Yoshida S | 2012 | Amino Acids2012，43，6： | 1 |
| 8 | 18F-FDG uptake as a biologic prognostic factor for recurrence in patients with surgically resected non-small cell lung cancer显示文摘 | Higashi K Ueda Y Arisaka Y | 2002 | J Nucl Med2002，43，1： | 1 |
| 9 | Silk fibroin of Bombyx mori is secreted, assembling a high molecular mass elementary unit consisting of H-chain, L-chain, and P25, with a 6 : 6 : 1 molar ratio显示文摘 | Inoue S Tanaka K Arisaka F | 2000 | J Biol Chem2000，275，40： | 1 |
| 10 | Serial EEG study in a girl with Landau-Kleffner syndrmne associated with continuous spikes and waves during slow sleep 显示文摘 | Imataka G Arisaka O | 2014 | Eur tlev Med Pharmacol Sci2014，18，15： | 1 |
| 11 | 18F-FDG uptake as a biologic prognostic factor for recurrence in patients with surgically resected non-small cell lung cancer显示文摘 | Higashi K Ueda Y Arisaka Y | 2002 | J Nucl Med2002，43，1： | 1 |
| 12 | High performance electrodes for medium-temperature solid oxide fuel cells: Activation of La(Sr) CoO3 cathode with highly dispersed Pt metal electrocatalysts 显示文摘 | Uchida H Arisaka S Watanabe M | 2000 | Solid States Ionics2000，135，： | 1 |
| 13 | Silk fibroin of Bom- byx mori is secreted,assembling a high molecular mass elementary unit consisting of H-chain,L-chain,and P25,with a 6:6:1 molar ratio显示文摘 | Inoue S Tanaka K Arisaka Y | 2000 | Journal of Biological Che- mistry2000，275，40： | 1 |
| 14 | Phytoestrogen concentrations in serum from Japanese men and women over forty years of age显示文摘 | MORTON M S ARISAKA O MIYAKE N | 2002 | J Nutr2002，132，10： | 1 |
| 15 | Silk fibroin of Bombyx mori is secreted, assembling a high molecular mass elementa- ry unit consisiting of H-chain, L-chain, and P25, with a 6:6: 1 molar ration显示文摘 | Inoue S Tanaka K Arisaka F | 2000 | Journal of Biological Chemistry2000，275，： | 1 |
| 16 | Silk fibroin of Bombyx mori is secreted,assembling a high molecular mass elementary unit consisting of H-chain,L-chain,and P25,with a 6:6:1 molar ratio显示文摘 | Inoue S Tanaka K Arisaka F | 2000 | J Biol Chem2000，275，40： | 1 |
| 17 | Silk fibroin of Bombyx mori is secreted,assembling a high molecular mass elementary unit consisting of H-chain,L-chain,and P25,with a 6:6:1molar ratio显示文摘 | Inoue S Tanaka K Arisaka F | 2000 | J Biol Chem2000，275，40： | 1 |
| 18 | Silk fibroin of Bombyx mori issecreted,assembling a high molecular mass elementary unit consis-ting of H-chain,L-chain,and P25,with a 6:6:1 molar ratio显示文摘 | Inoue S Tanaka K Arisaka F | 2000 | JBiol Chem2000，275，40： | 1 |
| 19 | 18F-FDG uptake as a biologic prognostic factor for recurrence in patients with surgically resected non-small cell lung cancer显示文摘 | Higashi K Ueda Y Arisaka Y | 2002 | J Nucl Med2002，43，1： | 1 |
| 20 | Biologically inactive growth hormone caused by an amino acid substitution显示文摘 | Takahashi Y Shirono H Arisaka O | 1997 | J Clin Invest1997，100，4： | 1 |
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