Effective utilization of polypectomy in endoscopic salvage treatment of rectal neuroendocrine tumors: a retrospective cohort study.

IF 1.2 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2024-08-26 DOI:10.4174/astr.2024.107.3.151

Yeonuk Ju,Jun Woo Bong,Chinock Cheong,Sanghee Kang,Byung Wook Min,Sun Il Lee

{"title":"Effective utilization of polypectomy in endoscopic salvage treatment of rectal neuroendocrine tumors: a retrospective cohort study.","authors":"Yeonuk Ju,Jun Woo Bong,Chinock Cheong,Sanghee Kang,Byung Wook Min,Sun Il Lee","doi":"10.4174/astr.2024.107.3.151","DOIUrl":null,"url":null,"abstract":"Purpose\r\nCurrent guidelines recommend endoscopic resection for rectal neuroendocrine tumors (RNETs) under 10 mm. Incomplete resections necessitate salvage procedures, highlighting the need for complete R0 resection. This study evaluates the efficacy and safety of wide hot snare polypectomy (WHSP) compared to endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for the salvage treatment of small RNETs.\r\n\r\nMethods\r\nThis retrospective study was conducted at Korea University Guro Hospital from January 2018 to December 2022. It compared the outcomes of salvage resections for RNETs ≤10 mm using 2 approaches: ESD and EMR vs. WHSP. Demographics, tumor characteristics, and clinical outcomes were compared. Efficacy was evaluated by the histological complete resection rate and procedure time, while safety was assessed by the incidence of complications.\r\n\r\nResults\r\nOut of 135 patients undergoing salvage resection for RNET, 14 who underwent transanal excision were excluded. Of the remaining 121, 99 underwent EMR or ESD, and 22 underwent WHSP. Baseline characteristics were similar between the 2 groups. The WHSP group demonstrated a significantly higher R0 resection rate (72.7% vs. 49.5%, P = 0.010) and a shorter median procedure time (3.5 minutes vs. 8.3 minutes). No complications were reported in the WHSP group.\r\n\r\nConclusion\r\nWHSP is a rapid, straightforward, safe, and effective approach for the salvage treatment of RNETs less than 10 mm in diameter, particularly in patients without additional risk factors.","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Surgical Treatment and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4174/astr.2024.107.3.151","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose Current guidelines recommend endoscopic resection for rectal neuroendocrine tumors (RNETs) under 10 mm. Incomplete resections necessitate salvage procedures, highlighting the need for complete R0 resection. This study evaluates the efficacy and safety of wide hot snare polypectomy (WHSP) compared to endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for the salvage treatment of small RNETs. Methods This retrospective study was conducted at Korea University Guro Hospital from January 2018 to December 2022. It compared the outcomes of salvage resections for RNETs ≤10 mm using 2 approaches: ESD and EMR vs. WHSP. Demographics, tumor characteristics, and clinical outcomes were compared. Efficacy was evaluated by the histological complete resection rate and procedure time, while safety was assessed by the incidence of complications. Results Out of 135 patients undergoing salvage resection for RNET, 14 who underwent transanal excision were excluded. Of the remaining 121, 99 underwent EMR or ESD, and 22 underwent WHSP. Baseline characteristics were similar between the 2 groups. The WHSP group demonstrated a significantly higher R0 resection rate (72.7% vs. 49.5%, P = 0.010) and a shorter median procedure time (3.5 minutes vs. 8.3 minutes). No complications were reported in the WHSP group. Conclusion WHSP is a rapid, straightforward, safe, and effective approach for the salvage treatment of RNETs less than 10 mm in diameter, particularly in patients without additional risk factors.

查看原文本刊更多论文

在直肠神经内分泌肿瘤的内镜挽救治疗中有效利用息肉切除术：一项回顾性队列研究。

目的现行指南建议对10毫米以下的直肠神经内分泌肿瘤（RNET）进行内窥镜切除。如果切除不彻底，就必须进行挽救手术，这凸显了完全R0切除的必要性。本研究评估了宽热网膜息肉切除术（WHSP）与内镜下粘膜下剥离术（ESD）和内镜下粘膜切除术（EMR）相比，对小型RNETs进行挽救性治疗的有效性和安全性。方法这项回顾性研究于2018年1月至2022年12月在韩国大学九老医院进行。该研究比较了使用两种方法对≤10毫米的RNET进行挽救性切除的结果：ESD和EMR vs. WHSP。比较了人口统计学、肿瘤特征和临床结果。根据组织学完全切除率和手术时间评估疗效，根据并发症发生率评估安全性。其余121人中，99人接受了EMR或ESD，22人接受了WHSP。两组患者的基线特征相似。WHSP 组的 R0 切除率明显更高（72.7% 对 49.5%，P = 0.010），中位手术时间更短（3.5 分钟对 8.3 分钟）。结论WHSP是挽救治疗直径小于10毫米的RNET的一种快速、直接、安全和有效的方法，尤其适用于无其他风险因素的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).