Objectives. Endoscopic submucosal dissection (ESD) has become a well-established treatment method for gastric submucosal tumors (SMTs). However, there existed some challenges to perform ESD for prepyloric SMTs on account of the special location. Recently, submucosal tunneling endoscopic resection (STER) provided a novel option for prepyloric SMTs. This study aimed to make a comprehensive comparison between prepyloric STER (P-STER) and ESD for the treatment of prepyloric SMTs. Methods. Patients with prepyloric SMTs undergoing P-STER treatment between January 2016 and October 2021 were retrospectively reviewed and individually matched at 1 : 1 ratio with those with ESD treatment according to lesion size, lesion location, pathologic diagnosis, lesion origin, and surgery date, forming P-STER and ESD group, respectively. A sample size of 12 patients was collected for each group. Treatment outcomes including resection time, en bloc resection rate, complete resection rate, and postoperative hospital stay as well as occurrence of complications were evaluated. Results. Compared with ESD group, P-STER group got shorter resection time (52.50 minutes for ESD group vs. 38.67 minutes for P-STER group, P = 0.001 ), shorter postoperative hospital stay (7.00 day for ESD group vs. 5.50 day for P-STER group, P = 0.008 ), and lower rate of postoperative abdominal pain (50.00% for ESD group vs. 8.33% for P-STER group, P = 0.025 ). No complication was encountered in P-STER group, whereas one patient with postoperative bleeding was found in ESD group. Conclusions. For the treatment of prepyloric SMTs, P-STER appeared to be a more effective endoscopic technique compared with ESD, although further randomized controlled trials were warranted.

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Objectives: At present, pancreaticoduodenectomy or local excision are the main treatment options for ampullary neuroendocrine tumors of any size with no distant spread. Endoscopic papillectomy provided a super minimally invasive treatment method for ampullary lesions. However, the studies of endoscopic papillectomy for ampullary neuroendocrine tumors were very limited. This study aimed to assess the feasibility of endoscopic papillectomy for ampullary neuroendocrine tumors. Methods: Between August 2007 and June 2021, seven patients with ampullary neuroendocrine tumors with no advanced signs underwent endoscopic papillectomy in our center. We assessed and analyzed the related clinical outcomes. Moreover, a comprehensive literature review was conducted. Results: All the seven cases underwent endoscopic papillectomy successfully; six (85.7%) of them achieved the complete resection. No recurrence occurred over a median follow-up of 48 months (range 6–172 months). Moreover, 22 cases from the comprehensive search were included, and showed a promising clinical outcome. Conclusions: Endoscopic papillectomy appeared to be a feasible way to treat ampullary neuroendocrine tumors without the advanced signs, although further prospectively multicenter studies are warranted.