Underwater Endoscopic Mucosal Resection of Small Rectal Neuroendocrine Tumors

Autor: Masahiro Okada, Satoshi Shinozaki, Eriko Ikeda, Yoshikazu Hayashi, Takahito Takezawa, Hisashi Fukuda, Takaaki Morikawa, Masafumi Kitamura, Munefumi Arita, Tatsuma Nomura, Hirotsugu Sakamoto, Keijiro Sunada, Noriyoshi Fukushima, Alan Kawarai Lefor, Hironori Yamamoto
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Frontiers in Medicine, Vol 9 (2022)
Druh dokumentu: article
ISSN: 2296-858X
DOI: 10.3389/fmed.2022.835013
Popis: Background and Study AimsThe resection strategy for rectal neuroendocrine tumors (NET) < 10 mm is not uniform. We compared the utility of underwater endoscopic mucosal resection (UEMR) to endoscopic submucosal resection with a ligation device (ESMR-L) to resect rectal NETs.Patients and MethodsPatients with rectal NET < 10 mm treated with UEMR or ESMR-L were included. Their medical records were retrospectively reviewed.ResultsThirty-two patients were divided into a UEMR group (n = 7) and an ESMR-L group (n = 25). Histopathological diagnosis of NET by biopsy was known before resection in 43% (3/7) in the UEMR group and 68% (17/25) in the ESMR-L group, (p = 0.379). UEMR was performed on an outpatient basis for all patients, and 92% of ESMR-L (23/25) were performed as inpatient procedures (p < 0.001). The procedure time was significantly shorter in the UEMR group than in the ESMR-L group [median (IQR), min, 6 (5–8) vs. 12 (9–14), p = 0.002]. En bloc resection and R0 resection rates were 100% in both groups. Pathological evaluations were predominantly NET G1 in both groups (UEMR: 7/7, 100% and ESMR-L: 23/25, 92%). Two patients in the ESMR-L group developed delayed bleeding, controlled by endoscopic hemostasis. Device costs were significantly higher in the ESMR-L group than the UEMR group by approximately US$180 [median (IQR), $90.45 (83.64–108.41) vs. $274.73 (265.86–292.45), P < 0.001].ConclusionUEMR results in similar resection quality with shorter procedure time and lower costs compared to ESMR-L. We recommend UEMR for the resection of rectal NET < 10 mm.
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