Abstract
Background and Aims. There is no consensus so far regarding the optimal endoscopic method for treatment of small rectal neuroendocrine tumor (NET). The aim of this study was to compare treatment efficacy, safety, and procedure time between endoscopic submucosal resection with band ligation (ESMR-L) and endoscopic submucosal dissection (ESD). Methods. We conducted a prospective study of patients who visited Inha University Hospital for endoscopic resection of rectal NET (≦10 mm). Pathological complete resection rate, procedure time, and complications were evaluated. Results. A total of 77 patients were treated by ESMR-L (n = 53) or ESD (n = 24). En bloc resection was achieved in all patients. A significantly higher pathological complete resection rate was observed in the ESMR-L group (53/53, 100%) than in the ESD group (13/24, 54.2%) (P = 0.000). The procedure time of ESD (17.9 ± 9.1 min) was significantly longer compared to that of ESMR-L (5.3 ± 2.8 min) (P = 0.000). Conclusions. Considering the clinical efficacy, technical difficulty, and procedure time, the ESMR-L method should be considered as the first-line therapy for the small rectal NET (≤10 mm). ESD should be left as a second-line treatment for the fibrotic lesion which could not be removed using the ESMR-L method.
Highlights
Rectal neuroendocrine tumor (NET) are rare tumors, most of which are diagnosed incidentally during routine colonoscopy
Small rectal NET (≤10 mm) confined to the submucosal layer without lymphovascular invasion is considered a good candidate for endoscopic resection [7]
According to ENETS consensus, endoscopic treatment is regarded as the appropriate therapy for small rectal NET (≤10 mm) [7]
Summary
Rectal NETs are rare tumors, most of which are diagnosed incidentally during routine colonoscopy. In Korea, screening colonoscopy is recommended from the age of 50 in the average-risk group and follow-up colonoscopy is recommended every 5 years when index colonoscopy is negative [5] Because of such a colon cancer screening program, the chance of encountering small rectal NET (≤10 mm) has increased. The aim of this study was to compare treatment efficacy, safety, and procedure time between endoscopic submucosal resection with band ligation (ESMR-L) and endoscopic submucosal dissection (ESD). A significantly higher pathological complete resection rate was observed in the ESMR-L group (53/53, 100%) than in the ESD group (13/24, 54.2%) (P = 0.000). Considering the clinical efficacy, technical difficulty, and procedure time, the ESMR-L method should be considered as the firstline therapy for the small rectal NET (≤10 mm). ESD should be left as a second-line treatment for the fibrotic lesion which could not be removed using the ESMR-L method
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
