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Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD

OBJECTIVES: There are some endoscopic resection (ER) methods for neuroendocrine tumors (NETs), however, which method is most useful remains unclear. This study aimed to compare the outcomes of different ER techniques, such as conventional endoscopic mucosal resection (cEMR), endoscopic submucosal di...

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Autores principales: Kamigaichi, Yuki, Yamashita, Ken, Oka, Shiro, Tamari, Hirosato, Shimohara, Yasutsugu, Nishimura, Tomoyuki, Inagaki, Katsuaki, Okamoto, Yuki, Tanaka, Hidenori, Yuge, Ryo, Urabe, Yuji, Arihiro, Koji, Tanaka, Shinji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8828204/
https://www.ncbi.nlm.nih.gov/pubmed/35310732
http://dx.doi.org/10.1002/deo2.35
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author Kamigaichi, Yuki
Yamashita, Ken
Oka, Shiro
Tamari, Hirosato
Shimohara, Yasutsugu
Nishimura, Tomoyuki
Inagaki, Katsuaki
Okamoto, Yuki
Tanaka, Hidenori
Yuge, Ryo
Urabe, Yuji
Arihiro, Koji
Tanaka, Shinji
author_facet Kamigaichi, Yuki
Yamashita, Ken
Oka, Shiro
Tamari, Hirosato
Shimohara, Yasutsugu
Nishimura, Tomoyuki
Inagaki, Katsuaki
Okamoto, Yuki
Tanaka, Hidenori
Yuge, Ryo
Urabe, Yuji
Arihiro, Koji
Tanaka, Shinji
author_sort Kamigaichi, Yuki
collection PubMed
description OBJECTIVES: There are some endoscopic resection (ER) methods for neuroendocrine tumors (NETs), however, which method is most useful remains unclear. This study aimed to compare the outcomes of different ER techniques, such as conventional endoscopic mucosal resection (cEMR), endoscopic submucosal dissection (ESD), and endoscopic submucosal resection with a ligation device (ESMR‐L) for rectal NETs. METHODS: We retrospectively analyzed 96 consecutive patients with 102 rectal NETs of less than 10 mm in diameter who underwent ER between January 2001 and December 2019 at Hiroshima University Hospital. We compared the clinical outcomes of each ER method (cEMR 60 lesions, ESD 21 lesions, and ESMR‐L 21 lesions), divided according to the treatment periods, and evaluated the risk factors for vertical margin (VM) positivity in relation to clinicopathological and endoscopic characteristics. RESULTS: As for the mean procedure time, ESD took significantly longer to perform than the other methods. The histological complete resection rate was 80% (48/60) for cEMR, 85.7% (18/21) for ESD, and 100% (21/21) for ESMR‐L, and the VM positive rate was 20% (12/60) for cEMR, 14.3% (3/21) for ESD, and 0% (0/21) for ESMR‐L, with no significant difference. However, the tumor‐front‐to‐VM distance was significantly longer in the ESMR‐L group than in the cEMR and ESD groups. cEMR and ESD were both significant risk factors for VM positivity. No perforation or local recurrence was observed in all methods. CONCLUSIONS: ESMR‐L is the most useful ER method for small rectal NETs.
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spelling pubmed-88282042022-03-17 Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD Kamigaichi, Yuki Yamashita, Ken Oka, Shiro Tamari, Hirosato Shimohara, Yasutsugu Nishimura, Tomoyuki Inagaki, Katsuaki Okamoto, Yuki Tanaka, Hidenori Yuge, Ryo Urabe, Yuji Arihiro, Koji Tanaka, Shinji DEN Open Original Articles OBJECTIVES: There are some endoscopic resection (ER) methods for neuroendocrine tumors (NETs), however, which method is most useful remains unclear. This study aimed to compare the outcomes of different ER techniques, such as conventional endoscopic mucosal resection (cEMR), endoscopic submucosal dissection (ESD), and endoscopic submucosal resection with a ligation device (ESMR‐L) for rectal NETs. METHODS: We retrospectively analyzed 96 consecutive patients with 102 rectal NETs of less than 10 mm in diameter who underwent ER between January 2001 and December 2019 at Hiroshima University Hospital. We compared the clinical outcomes of each ER method (cEMR 60 lesions, ESD 21 lesions, and ESMR‐L 21 lesions), divided according to the treatment periods, and evaluated the risk factors for vertical margin (VM) positivity in relation to clinicopathological and endoscopic characteristics. RESULTS: As for the mean procedure time, ESD took significantly longer to perform than the other methods. The histological complete resection rate was 80% (48/60) for cEMR, 85.7% (18/21) for ESD, and 100% (21/21) for ESMR‐L, and the VM positive rate was 20% (12/60) for cEMR, 14.3% (3/21) for ESD, and 0% (0/21) for ESMR‐L, with no significant difference. However, the tumor‐front‐to‐VM distance was significantly longer in the ESMR‐L group than in the cEMR and ESD groups. cEMR and ESD were both significant risk factors for VM positivity. No perforation or local recurrence was observed in all methods. CONCLUSIONS: ESMR‐L is the most useful ER method for small rectal NETs. John Wiley and Sons Inc. 2021-09-01 /pmc/articles/PMC8828204/ /pubmed/35310732 http://dx.doi.org/10.1002/deo2.35 Text en © 2021 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Kamigaichi, Yuki
Yamashita, Ken
Oka, Shiro
Tamari, Hirosato
Shimohara, Yasutsugu
Nishimura, Tomoyuki
Inagaki, Katsuaki
Okamoto, Yuki
Tanaka, Hidenori
Yuge, Ryo
Urabe, Yuji
Arihiro, Koji
Tanaka, Shinji
Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD
title Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD
title_full Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD
title_fullStr Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD
title_full_unstemmed Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD
title_short Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD
title_sort clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: advantages of endoscopic submucosal resection with a ligation device compared to conventional emr and esd
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8828204/
https://www.ncbi.nlm.nih.gov/pubmed/35310732
http://dx.doi.org/10.1002/deo2.35
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