Endoscopic Submucosal Resection Using a Ligation Band without Injection for Rectal Neuroendocrine Tumors.

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy Pub Date : 2025-07-02 DOI:10.1016/j.gie.2025.06.045

Tomoya Ueda, Shunsuke Yoshii, Takashi Kanesaka, Yasuhiro Tani, Yoshiaki Ando, Gentaro Tanabe, Yuya Fujimoto, Noriaki Ito, Nobutoshi Tsukuda, Kazuki Matsuyama, Muneshin Morita, Minoru Kato, Satoki Shichijo, Sachiko Yamamoto, Koji Higashino, Noriya Uedo, Tomoki Michida, Ryu Ishihara

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引用次数: 0

Abstract

Background and aims: The most appropriate endoscopic resection procedure for small rectal neuroendocrine tumors (NETs) remains unclear. We aimed to evaluate the usefulness of endoscopic submucosal resection using a ligation band (ESMR-L) without submucosal injection compared to ESMR-L with submucosal injection.

Methods: This single-center retrospective study included rectal NETs (≤10 mm) treated with ESMR-L between March 2017 and July 2024. The primary endpoint was sufficient vertical R0 (SVR0) resection, defined as R0 resection with tumor-free vertical margin ≥500 μm.

Results: Of 102 rectal NETs treated with ESMR-L, 71 were resected with injection and 31 without injection. Tumor-free vertical margin distance was significantly greater in ESMR-L without injection (1070 vs. 430 μm, P < 0.001). ESMR-L without injection achieved a significantly higher SVR0 resection rate (67.7% vs. 40.8%, P = 0.018) without an increase in adverse events.

Conclusions: ESMR-L without injection can be simpler and more effective for small rectal NETs than ESMR-L with injection.

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内镜下粘膜下结扎带不注射切除直肠神经内分泌肿瘤。

背景和目的：直肠小神经内分泌肿瘤（NETs）最合适的内镜切除手术尚不清楚。我们的目的是评估不进行粘膜下注射的结扎带内镜下粘膜下切除术（ESMR-L）与进行粘膜下注射的ESMR-L的有效性。方法：这项单中心回顾性研究包括2017年3月至2024年7月期间接受ESMR-L治疗的直肠NETs（≤10 mm）。主要终点为足够的垂直R0 （SVR0）切除，定义为R0切除无肿瘤垂直切缘≥500 μm。结果：ESMR-L治疗102例直肠NETs， 71例经注射切除，31例不经注射切除。未注射ESMR-L的无肿瘤垂直切缘距离显著增加（1070 μm vs 430 μm, P < 0.001）。未注射ESMR-L的SVR0切除率明显更高（67.7% vs. 40.8%, P = 0.018），且不良事件未增加。结论：不注射ESMR-L治疗直肠小NETs比注射ESMR-L更简单、更有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastrointestinal endoscopy 医学-胃肠肝病学

CiteScore

10.30

自引率

7.80%

发文量

1441

审稿时长

38 days

期刊介绍： Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.