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Surgical Endoscopy
Published in: Surgical Endoscopy 10/2014

01-10-2014

A tailored approach for endoscopic treatment of small rectal neuroendocrine tumor

Authors: Jun Heo, Seong Woo Jeon, Min Kyu Jung, Sung Kook Kim, Geun Young Shin, Sang Man Park, Sun Young Ahn, Won Kyung Yoon, Min Kim, Yong Hwan Kwon

Published in: Surgical Endoscopy | Issue 10/2014

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Abstract

Introduction

Resection of rectal neuroendocrine tumors (NETs) less than 1 cm in diameter can be performed using various endoscopic techniques. Endoscopic mucosal resection (EMR) traditionally had suboptimal complete resection rate compared to endoscopic submucosal resection with band ligation (ESMR-L). However, the previous studies did not consider the characteristics of rectal NETs. The aim of our study is to compare the efficacy of ESMR-L and EMR using tailored approach according to the characteristics of rectal NETs.

Methods

82 rectal NETs in 77 patients treated by ESMR-L (n = 48) or EMR (n = 34) between September 2007 and October 2012 were retrospectively analyzed. ESMR-L was used for flat-type tumors or tumors with non-lifting sign after submucosal injection. Conventional EMR was used for elevated-type tumors or tumors with well-lifting sign after submucosal injection.

Results

The pathological complete resection rate was higher in the ESMR-L group (45 lesions, 93.8 %) compared with the EMR group (30 lesions, 88.2 %); however, this difference was not significant (p = 0.441). Overall complication did not differ significantly between the ESMR-L group and the EMR group (p = 0.774). There was one case of a remnant lesion in the ESMR-L group, which was managed by EMR after circumferential pre-cutting (EMR-P), and no recurrence has been detected in either the ESMR-L or EMR group.

Conclusions

ESMR-L and EMR procedures could have a similar excellent complete resection rate, if we select the endoscopic resection technique according to the characteristics of the small rectal NETs.
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Metadata
Title
A tailored approach for endoscopic treatment of small rectal neuroendocrine tumor
Authors
Jun Heo
Seong Woo Jeon
Min Kyu Jung
Sung Kook Kim
Geun Young Shin
Sang Man Park
Sun Young Ahn
Won Kyung Yoon
Min Kim
Yong Hwan Kwon
Publication date
01-10-2014
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 10/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3555-1

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