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

BACKGROUND: To compare the outcomes of modified endoscopic mucosal resection (m-EMR) and endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors (NETs) and evaluate the value of endoscopic morphology classification in endoscopic resection (ER).

METHODS: Patients with rectal NET diameters less than 2 cm who were treated between April 2007 and January 2019 were enrolled. The endoscopic morphology of rectal NETs was classified based on the endoscopic views. Patients who underwent ESD and m-EMR were compared. Baseline characteristics as well as en bloc resection, complete resection, the procedure time, adverse events and the risk factors associated with incomplete resection were analyzed.

RESULTS: A total of 429 patients with 449 rectal NETs were enrolled for the classification of endoscopic morphology and were classified into four types (Ia, IIb, II, and III). There were 79 patients in the m-EMR group and 259 patients in the ESD group before matching. Propensity score matching created 77 pairs between the two groups that were well balanced. The mean procedure time was significantly shorter for m-EMR than for ESD (9.1 ± 4.4 min vs 16.0 ± 7.9 min, P = 0.000). The rates of en bloc resection (98.7% vs 100%; P = 1.000), complete resection (90.9% vs 93.5%, P = 0.548) and adverse events (2.6% vs 2.6%, P = 1.000) were similar between the two groups. Univariate and multivariate analyses showed that histopathological grade and endoscopic morphology were associated with incomplete resection.

CONCLUSION: Both ESD and m-EMR are effective and safe for the treatment of rectal NETs. Endoscopic morphology should be considered along with histopathological grade for ER.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:20

Enthalten in:

BMC gastroenterology - 20(2020), 1 vom: 26. Juni, Seite 200

Sprache:

Englisch

Beteiligte Personen:

Wang, Xiang-Yao [VerfasserIn]
Chai, Ning-Li [VerfasserIn]
Linghu, En-Qiang [VerfasserIn]
Qiu, Shao-Tian [VerfasserIn]
Li, Long-Song [VerfasserIn]
Zou, Jia-Le [VerfasserIn]
Xiang, Jing-Yuan [VerfasserIn]
Li, Xing-Xing [VerfasserIn]

Links:

Volltext

Themen:

ESD
Endoscopic morphology classification
Journal Article
M-EMR
Rectal neuroendocrine tumors

Anmerkungen:

Date Completed 14.05.2021

Date Revised 14.05.2021

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s12876-020-01340-w

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM311645933