Korean J Gastroenterol.  2018 Sep;72(3):128-134. 10.4166/kjg.2018.72.3.128.

Endoscopic Treatment Outcome of Rectal Neuroendocrine Tumors Removed by Ligation-assisted Endoscopic Submucosal Resection

• Gu MG
• Lee SH

• KMID: 2420750
• DOI: http://doi.org/10.4166/kjg.2018.72.3.128

Abstract

BACKGROUND/AIMS
Ligation-assisted endoscopic submucosal resection (ESMR-L) is preferred for the treatment of rectal neuroendocrine tumors because its results are better than those for endoscopic mucosal resection (EMR), and the procedure time is shorter and the incidence of complications is lower than endoscopic submucosal dissection. The aim of this study was to evaluate the clinical usefulness of ESMR-L compared with EMR for rectal neuroendocrine tumors.
METHODS
From March 2007 to May 2017, 148 patients diagnosed with rectal neuroendocrine tumors were divided into ESMR-L and EMR groups and analyzed retrospectively.
RESULTS
Of 148 patients with rectal neuroendocrine tumor, 120 had ESMR-L and 28 had EMR. The ESMR-L group had a significantly higher rate of complete resection and curative resection than the EMR group (93.3% vs. 75.0% and 92.5% vs. 71.4%, p=0.009 and p=0.003, respectively).
CONCLUSIONS
ESMR-L for the treatment of small rectal neuroendocrine is a significantly superior modality to EMR.

Keyword

Rectum; Neuroendocrine tumors; Ligation; Endoscopic mucosal resection

MeSH Terms

Humans
Incidence
Ligation
Neuroendocrine Tumors*
Rectum
Retrospective Studies
Treatment Outcome*

Figure

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  Fig. 1. Endoscopic mucosal resection. (A) Submucosal tumor is observed. (B) Submucosal saline mixed with epinephrine and indigo carmine solution is injected beneath the neuroendocrine tumor. (C) Elevated tumor is snared. (D) Tumor is resected using high-frequency currents.

• 

  Fig. 2. Endoscopic submucosal resection with a ligation device. (A) Submucosal saline mixed with epinephrine and indigo carmine solution is injected beneath the neuroendocrine tumor. (B) The lesion is aspirated into the ligation device and elastic band is deployed. (C) Snaring below the elastic band. (D) After resection, clear ulcer surface is observed.

Reference

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