A tailored approach for endoscopic treatment of small rectal neuroendocrine tumor

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

doi:10.1007/s00464-014-3555-1

A tailored approach for endoscopic treatment of small rectal neuroendocrine tumor

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

Department of Medicine

Kyungpook National University

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

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.

Original language	English
Pages (from-to)	2931-2938
Number of pages	8
Journal	Surgical Endoscopy and Other Interventional Techniques
Volume	28
Issue number	10
DOIs	https://doi.org/10.1007/s00464-014-3555-1
State	Published - Oct 2014

Keywords

Endoscopic mucosal resection
Endoscopic submucosal resection with band ligation
Rectal neuroendocrine tumor

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@article{9dbf86e8a492431bb83463bb62d85bb9,

title = "A tailored approach for endoscopic treatment of small rectal neuroendocrine tumor",

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.",

keywords = "Endoscopic mucosal resection, Endoscopic submucosal resection with band ligation, Rectal neuroendocrine tumor",

author = "Jun Heo and Jeon, {Seong Woo} and Jung, {Min Kyu} and Kim, {Sung Kook} and Shin, {Geun Young} and Park, {Sang Man} and Ahn, {Sun Young} and Yoon, {Won Kyung} and Min Kim and Kwon, {Yong Hwan}",

note = "Publisher Copyright: {\textcopyright} 2014, Springer Science+Business Media New York.",

year = "2014",

month = oct,

doi = "10.1007/s00464-014-3555-1",

language = "English",

volume = "28",

pages = "2931--2938",

journal = "Surgical Endoscopy and Other Interventional Techniques",

issn = "0930-2794",

publisher = "Springer",

number = "10",

}

TY - JOUR

T1 - A tailored approach for endoscopic treatment of small rectal neuroendocrine tumor

AU - Heo, Jun

AU - Jeon, Seong Woo

AU - Jung, Min Kyu

AU - Kim, Sung Kook

AU - Shin, Geun Young

AU - Park, Sang Man

AU - Ahn, Sun Young

AU - Yoon, Won Kyung

AU - Kim, Min

AU - Kwon, Yong Hwan

PY - 2014/10

Y1 - 2014/10

N2 - 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.

AB - 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.

KW - Endoscopic mucosal resection

KW - Endoscopic submucosal resection with band ligation

KW - Rectal neuroendocrine tumor

UR - http://www.scopus.com/inward/record.url?scp=84935492304&partnerID=8YFLogxK

U2 - 10.1007/s00464-014-3555-1

DO - 10.1007/s00464-014-3555-1

M3 - Article

C2 - 24853847

AN - SCOPUS:84935492304

SN - 0930-2794

VL - 28

SP - 2931

EP - 2938

JO - Surgical Endoscopy and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

IS - 10

ER -

A tailored approach for endoscopic treatment of small rectal neuroendocrine tumor

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