Abstract
PurposeLocal treatment of small well-differentiated rectal neuroendocrine tumors (NETs) is recommended by current guidelines. However, although several endoscopic methods have been established, the highest R0 rate is achieved by transanal endoscopic microsurgery (TEM). Since a recently published study about endoscopic full thickness resection (eFTR) showed a R0 resection rate of 100%, the aim of this study was to evaluate both methods (eFTR vs. TEM).MethodsWe retrospectively analyzed all patients with rectal NET treated either by TEM (1999–2018) or eFTR (2016–2019) in two tertiary centers (University Hospital Wuerzburg and Ulm). We analyzed clinical, procedural, and histopathological outcomes in both groups.ResultsTwenty-eight patients with rectal NET received local treatment (TEM: 13; eFTR: 15). Most tumors were at stage T1a and grade G1 or G2 (in the TEM group two G3 NETs were staged T2 after neoadjuvant chemotherapy). In both groups, similar outcomes for en bloc resection rate, R0 resection rate, tumor size, or specimen size were found. No procedural adverse events were noted. Mean procedure time in the TEM group was 48.9 min and 19.2 min in the eFTR group.ConclusioneFTR is a convincing method for local treatment of small rectal NETs combining high safety and efficacy with short interventional time.
Highlights
Well differentiated neuroendocrine tumors (NETs) of the rectum are rare and often present as asymptomatic incidental findings during colonoscopy [1]
We found 28 patients with rectal NET who received local treatment either by transanal endoscopic microsurgery (TEM) (13 patients between 1999 and 2018) or endoscopic full thickness resection (eFTR) (15 patients between 2016 and 2019)
In one eFRT procedure, no residual tumor cells were found in the specimen after initial biopsies - the rectal NET was already completely removed by biopsies
Summary
Well differentiated neuroendocrine tumors (NETs) of the rectum are rare and often present as asymptomatic incidental findings during colonoscopy [1]. Due to higher participation rates of patients to screening colonoscopies, these submucosal. Int J Colorectal Dis (2021) 36:971–976 resection rates according to advanced/invasive techniques [4,5,6,7,8]. A recent publication reported excellent R0 rates, using eFTR for rectal NET treatment. Data comparing eFTR with other techniques is still missing [9]. We aim to analyze the outcome of eFTR and TEM in local treatment of rectal NETs
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