Journal of Internal Medicine Concepts & Practice >
Management of rectal neurosecretory tumors less than 1 cm in diameter: comparison of two endoscopic procedures
Received date: 2022-04-17
Online published: 2022-08-08
Objective To compare the efficacy and safety of endoscopic submucosal resection with ligation (ESMR-L) with non-submucosal injection and endoscopic submucosal dissection (ESD) on management of rectal neuroendocrine tumor (NET). Methods The prospective study included 42 patients who had rectal NET with a diameter ≤1 cm and received endoscopic treatment in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from October 2020 through October 2021. Twenty-one patients were treated with ESD and 21 patients were treated with non-submucosal injection ESMR-L. The average operation time and histopathological characteristics, such as complete resection rate and the distance between the lower edge of the tumor and the vertical cutting edge, were compared between the two groups. Results The operation time in non-submucosal injection ESMR-L group was significantly shorter than that in ESD group[(10.10±1.37) min vs (29.90±3.81) min, P<0.001]; The lateral and vertical margins of the two groups were both negative, and patients of both group all had the lesions complete resected (P>0.05); The distance from the lower edge of tumor to the vertical cutting edge in non-submucosal injection ESMR-L group was significantly longer than that in ESD group [(1 051.5±561.4) μm vs(612.6±305.4) μm, P=0.038]. Conclusions Compared with the ESD method, non-submucosal ESMR-L method needs shorter operation time while achieving similar rate of complete lesion resection. ESMR-L is therefore a simple, safe and effective treatment for rectal NET with diameter ≤1 cm.
LI Weiguang, SUN Yunwei, SUN Jing, ZHANG Benyan, WANG Huafeng, QIAN Aihua . Management of rectal neurosecretory tumors less than 1 cm in diameter: comparison of two endoscopic procedures[J]. Journal of Internal Medicine Concepts & Practice, 2022 , 17(04) : 289 -294 . DOI: 10.16138/j.1673-6087.2022.04.004
[1] | Clift AK, Kidd M, Bodei L, et al. Neuroendocrine neoplasms of the small bowel and pancreas[J]. Neuroendocrinology, 2020, 110(6): 444-476. |
[2] | Desai H, Borges-Neto S, Wong TZ. Molecular imaging and therapy for neuroendocrine tumors[J]. Curr Treat Options Oncol, 2019, 20(10): 78. |
[3] | Hrabe J. Neuroendocrine tumors of the appendix, colon, and rectum[J]. Surg Oncol Clin N Am, 2020, 29(2): 267-279. |
[4] | de Mestier L, Cadiot G. Rectal neuroendocrine tumors: is it all on first sight?[J]. Endoscopy, 2021, 53(7): 710-712. |
[5] | Gonzalez RS. Diagnosis and management of gastrointestinal neuroendocrine neoplasms[J]. Surg Pathol Clin, 2020, 13(3): 377-397. |
[6] | Kamigaichi Y, Yamashita K, Oka S, et al. Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD[J]. DEN Open, 2021, 2(1): e35. |
[7] | Gallo C, Rossi RE, Cavalcoli F, et al. Rectal neuroendocrine tumors: current advances in management, treatment, and surveillance[J]. World J Gastroenterol, 2022, 28(11): 1123-1138. |
[8] | Hayashi S, Takayama T, Ikarashi M, et al. Transanal minimally invasive surgery for rectal neuroendocrine tumors[J]. Surg Endosc, 2021, 35(12): 6746-6753. |
[9] | Lim HK, Lee SJ, Baek DH, et al. Resectability of rectal neuroendocrine tumors using endoscopic mucosal resection with a ligation band device and endoscopic submucosal dissection[J]. Gastroenterol Res Pract, 2019, 2019: 8425157. |
[10] | Tanaka S, Saitoh Y, Matsuda T, et al. Evidence-based clinical practice guidelines for management of colorectal polyps[J]. J Gastroenterol, 2021, 56(4): 323-335. |
[11] | Chung HG, Goh MJ, Kim ER, et al. Recurrence pattern and surveillance strategy for rectal neuroendocrine tumors after endoscopic resection[J]. J Gastroenterol Hepatol, 2021, 36(4): 968-973. |
[12] | Coutinho LMA, Lenz L, Kawaguti FS, et al. Underwater endoscopic mucosal resection for small rectal neuroendocrine tumors[J]. Arq Gastroenterol, 2021, 58(2): 210-213. |
[13] | Sun P, Zheng T, Hu C, et al. Comparison of endoscopic therapies for rectal neuroendocrine tumors: endoscopic submucosal dissection with myectomy versus endoscopic submucosal dissection[J]. Surg Endosc, 2021, 35(11): 6374-6378. |
[14] | Amorim LC, Ferreira AR, Perez RO, et al. Localized well-differentiated rectal neuroendocrine tumors - where are we in 2021?[J]. Clin Colorectal Cancer, 2022, 21(1): e22-e27. |
[15] | Lee HS, Moon HS, Kwon IS, et al. Comparison of conventional and modified endoscopic mucosal resection methods for the treatment of rectal neuroendocrine tumors[J]. Surg Endosc, 2021, 35(11): 6055-6065. |
[16] | Liu S, Chai N, Linghu E. et al. Underwater EMR or endoscopic submucosal dissection for rectal neuroendocrine tumors: what are the advantages?[J]. Gastrointest Endosc, 2020, 92(1): 230-231. |
[17] | Park SS, Kim BC, Lee DE, et al. Comparison of endoscopic submucosal dissection and transanal endoscopic microsurgery for T1 rectal neuroendocrine tumors: a propensity score-matched study[J]. Gastrointest Endosc, 2021, 94(2): 408-415. |
[18] | Zheng JC, Zheng K, Zhao S, et al. Efficacy and safety of modified endoscopic mucosal resection for rectal neuroendocrine tumors[J]. Z Gastroenterol, 2020, 58(2):137-145. |
[19] | He L, Wen W, Ye L, et al. Endoscopic mucosal resection with double band ligation for small rectal neuroendocrine tumors[J]. Am J Gastroenterol, 2021, 116(9): 1827-1828. |
[20] | Wang XY, Chai NL, Linghu EQ, et al. The outcomes of modified endoscopic mucosal resection and endoscopic submucosal dissection for the treatment of rectal neuroendocrine tumors and the value of endoscopic morphology classification in endoscopic resection[J]. BMC Gastroenterol, 2020, 20(1): 200. |
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