Korean J Intern Med.
2024 Mar;39(2):238-247. 10.3904/kjim.2023.263.
Endoscopic mucosal resection using anchored snare Tip-in versus precut technique for small rectal neuroendocrine tumors
- Affiliations
-
- 1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Seoul, Korea
- 2Division of Gastroenterology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
- 3Division of Gastroenterology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
- 4Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 5Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
- 6Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 7Department of Internal Medicine, Chonnam National Medical School, Gwangju, Korea
- KMID: 2552943
- DOI: http://doi.org/10.3904/kjim.2023.263
Abstract
- Background/Aims
Small rectal neuroendocrine tumors (NETs) can be treated with modified endoscopic mucosal resection (EMR). However, an optimal EMR method remains to be established. We aimed to assess the non-inferiority of Tip-in EMR versus precut EMR (EMR-P) for treating rectal NETs.
Methods
This prospective, multicenter, randomized controlled trial enrolled patients with rectal NETs of < 10 mm in diameter. The patients were randomly assigned to EMR-P and Tip-in EMR groups in a 1:1 ratio. Primary outcome was margin-negative (R0) resection rate between the two methods, with a noninferiority margin of 10%.
Results
Seventy-five NETs in 73 patients, including 64 eligible lesions (32 lesions in each, EMR-P and Tip-in EMR groups), were evaluated. In a modified intention-to-treat analysis, R0 resection rates of the EMR-P and Tip-in EMR groups were 96.9% and 90.6%, respectively, which did not demonstrate non-inferiority (risk difference, -6.3 [95% confidence interval: -18.0 to 5.5]). Resection time in the EMR-P group was longer than that in the Tip-in EMR group (p < 0.001). One case of intraprocedural bleeding was reported in each group.
Conclusions
We did not demonstrate the non-inferiority of Tip-in EMR compared to EMR-P for treating small rectal NETs. However, the R0 resection rates for both techniques were high enough for clinical application.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Efficacy of Precut Endoscopic Mucosal Resection for Treatment of Rectal Neuroendocrine Tumors
- Proper Treatment Option for Small Rectal Neuroendocrine Tumors Using Precut Endoscopic Mucosal Resection
- Three Cases of Endoscopic Mucosal Resection of Rectal Carcinoid Tumor by Band Ligation and the Snare Resection Technique
- Endoscopic Treatment Outcome of Rectal Neuroendocrine Tumors Removed by Ligation-assisted Endoscopic Submucosal Resection
- Recurrence after endoscopic resection of small rectal neuroendocrine tumors: a retrospective cohort study
