Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD
Abstract 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 submu...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-04-01
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| Series: | DEN Open |
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| Online Access: | https://doi.org/10.1002/deo2.35 |
| _version_ | 1828396903002275840 |
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| author | Yuki Kamigaichi Ken Yamashita Shiro Oka Hirosato Tamari Yasutsugu Shimohara Tomoyuki Nishimura Katsuaki Inagaki Yuki Okamoto Hidenori Tanaka Ryo Yuge Yuji Urabe Koji Arihiro Shinji Tanaka |
| author_facet | Yuki Kamigaichi Ken Yamashita Shiro Oka Hirosato Tamari Yasutsugu Shimohara Tomoyuki Nishimura Katsuaki Inagaki Yuki Okamoto Hidenori Tanaka Ryo Yuge Yuji Urabe Koji Arihiro Shinji Tanaka |
| author_sort | Yuki Kamigaichi |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-10T08:39:27Z |
| format | Article |
| id | doaj.art-60975338120c4aafb9d8fb60d375c2fb |
| institution | Directory Open Access Journal |
| issn | 2692-4609 |
| language | English |
| last_indexed | 2024-12-10T08:39:27Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj.art-60975338120c4aafb9d8fb60d375c2fb2022-12-22T01:55:54ZengWileyDEN Open2692-46092022-04-0121n/an/a10.1002/deo2.35Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESDYuki Kamigaichi0Ken Yamashita1Shiro Oka2Hirosato Tamari3Yasutsugu Shimohara4Tomoyuki Nishimura5Katsuaki Inagaki6Yuki Okamoto7Hidenori Tanaka8Ryo Yuge9Yuji Urabe10Koji Arihiro11Shinji Tanaka12Department of Endoscopy Hiroshima University Hospital Hiroshima JapanDepartment of Endoscopy Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology and Metabolism Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology and Metabolism Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology and Metabolism Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology and Metabolism Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology and Metabolism Hiroshima University Hospital Hiroshima JapanDepartment of Gastroenterology and Metabolism Hiroshima University Hospital Hiroshima JapanDepartment of Endoscopy Hiroshima University Hospital Hiroshima JapanDepartment of Endoscopy Hiroshima University Hospital Hiroshima JapanDivision of Regeneration and Medicine Center for Translational and Clinical Research Hiroshima University Hospital Hiroshima JapanDepartment of Anatomical Pathology Hiroshima University Hospital Hiroshima JapanDepartment of Endoscopy Hiroshima University Hospital Hiroshima JapanAbstract 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.https://doi.org/10.1002/deo2.35endoscopic mucosal resectionendoscopic submucosal dissectionendoscopic submucosal resection with a ligation devicerectal neuroendocrine tumor |
| spellingShingle | Yuki Kamigaichi Ken Yamashita Shiro Oka Hirosato Tamari Yasutsugu Shimohara Tomoyuki Nishimura Katsuaki Inagaki Yuki Okamoto Hidenori Tanaka Ryo Yuge Yuji Urabe Koji Arihiro Shinji Tanaka Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD DEN Open endoscopic mucosal resection endoscopic submucosal dissection endoscopic submucosal resection with a ligation device rectal neuroendocrine tumor |
| 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 | endoscopic mucosal resection endoscopic submucosal dissection endoscopic submucosal resection with a ligation device rectal neuroendocrine tumor |
| url | https://doi.org/10.1002/deo2.35 |
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