Online Articles: Original ArticlesEfficacy of Endoscopic Mucosal Resection for Management of Small Duodenal Neuroendocrine TumorsShroff, Sagar R. MD; Kushnir, Vladimir M. MD; Wani, Sachin B. MD; Gupta, Neil MD; Jonnalagadda, Sreenivasa S. MD; Murad, Faris MD; Early, Dayna S. MD; Mullady, Daniel K. MD; Edmundowicz, Steven A. MD; Azar, Riad R. MDAuthor Information Department of Medicine, Division of Gastroenterology and Hepatology, Washington University, St Louis, MO The authors declare no conflicts of interest. Reprints: Vladimir M. Kushnir, MD, Department of Medicine, Division of Gastroenterology and Hepatology, Washington University, 660 South Euclid Ave, P.O. Box 8124, St Louis, MO 63110 (e-mail: firstname.lastname@example.org). Received February 2, 2015 Accepted June 30, 2015 Surgical Laparoscopy Endoscopy & Percutaneous Techniques: October 2015 - Volume 25 - Issue 5 - p e134-e139 doi: 10.1097/SLE.0000000000000192 Buy Metrics Abstract Background: Endoscopic mucosal resection (EMR) for small (<20 mm) duodenal neuroendocrine tumors (NETs) remains controversial because of their rarity. Materials and Methods: This is a retrospective cohort study of patients with surgically or endoscopically resected duodenal NETs from 2001 to 2011. The primary outcome is the rate of disease-free status following resection. A secondary outcome is the sensitivity of endoscopic ultrasound (EUS) in determining NET appropriateness for EMR. Results: Thirty patients underwent resection of duodenal NETs (EMR 20, surgery 10). Tumor was present at the margins in 40% of EMR-resected NETs and 10% of surgically resected NETs. Five patients who underwent EMR had residual disease treated with repeat EMR (3) and surgery (2). EUS demonstrated 96% sensitivity in determining lesions limited to the submucosa. Conclusions: EMR for small duodenal NETs can be a safe and effective alternative to surgery in carefully selected patients. EUS is a useful adjunct in determining depth of invasion for duodenal NETs. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.