Usefulness of endoscopic resection using the band ligation method for rectal neuroendocrine tumors

Kim, Ju Seung; Kim, Yoon Jae; Chung, Jun‐Won; Kim, Jung Ho; Kim, Kyoung Oh; Kwon, Kwang An; Park, Dong Kyun; An, Jung Suk

doi:10.5217/ir.2016.14.2.164

Cited by 12 publications

(10 citation statements)

References 32 publications

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“…EMR-L requires less technical skill, and snare resection below the band ligation is effective in achieving a negative vertical margin. Earlier evaluations have attested to the acceptable safety and outcomes of EMR-L treatment for rectal NET (8-10). The procedure can be performed safely within a short period of time and allows for a relatively precise histological assessment of the resected margin (11, 12).…”

Section: Introductionmentioning

confidence: 99%

Treatment Results of Endoscopic Mucosal Resection with a Ligation Device for Duodenal Neuroendocrine Tumors

et al. 2019

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Objective The vertical margin of neuroendocrine tumors (NETs) removed by endoscopic mucosal resection (EMR) is often tumor-positive. We examine the treatment results of endoscopic mucosal resection with a ligation device (EMR-L) for the removal of duodenal NETs located in the submucosal layer without metastasis. EMR-L can be performed with less technical skill, and the ligation device reduces the rate of positive vertical margin. Methods Ten consecutive patients with 10 duodenal NETs resected by EMR-L were enrolled. All of the lesions were located in the submucosal layer, were assessed to be free of metastasis, and were confirmed to be NETs pathologically by an endoscopic biopsy. The endoscopic results, pathological results, and prognosis were all examined. Results The en bloc resection rate and endoscopic complete resection rate were both 100%. Complete resection was achieved pathologically in 7 lesions (70.0%). The vertical margins were negative in all cases. Lymphatic vessel invasion was observed in three patients, all of whom underwent additional surgery with lymph node dissection (one of them also exhibited blood vessel invasion and a positive horizontal margin). No evidence of residual tumors or lymph node metastasis was observed in any of the patients. No recurrence was observed in any of the 10 patients (mean follow-up period: 18.6 months). One patient (10.0%) experienced intraoperative bleeding. Perforation occurred in 1 patient (10.0%), but the condition was managed well by conservative therapy. Conclusion EMR-L was an acceptable method for endoscopically resecting submucosal duodenal NETs, and the NETs resected by EMR-L were tumor-negative in the vertical margins.

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Section: Introductionmentioning

confidence: 99%

Treatment Results of Endoscopic Mucosal Resection with a Ligation Device for Duodenal Neuroendocrine Tumors

et al. 2019

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“…One of the most important reasons for the superior outcomes of ESMR‐L is its low VM positive rate. Previous reports revealed that the VM positive rate was 22.6–50% in cEMR, 23 , 25 , 26 , 27 , 28 0–29.2% in ESD, 13 , 23 , 25 , 29 and 0–10% in ESMR‐L. 13 , 23 , 25 , 26 , 28 , 29 …”

Section: Discussionmentioning

confidence: 94%

“…Previous reports revealed that the VM positive rate was 22.6–50% in cEMR, 23 , 25 , 26 , 27 , 28 0–29.2% in ESD, 13 , 23 , 25 , 29 and 0–10% in ESMR‐L. 13 , 23 , 25 , 26 , 28 , 29 …”

Section: Discussionmentioning

confidence: 94%

Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD

et al. 2021

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Objectives There are some endoscopic resection (ER) methods for neuroendocrine tumors (NETs), however, which method is most useful remains unclear. This study aimed to compare the outcomes of different ER techniques, such as conventional endoscopic mucosal resection (cEMR), endoscopic submucosal dissection (ESD), and endoscopic submucosal resection with a ligation device (ESMR‐L) for rectal NETs. Methods We retrospectively analyzed 96 consecutive patients with 102 rectal NETs of less than 10 mm in diameter who underwent ER between January 2001 and December 2019 at Hiroshima University Hospital. We compared the clinical outcomes of each ER method (cEMR 60 lesions, ESD 21 lesions, and ESMR‐L 21 lesions), divided according to the treatment periods, and evaluated the risk factors for vertical margin (VM) positivity in relation to clinicopathological and endoscopic characteristics. Results As for the mean procedure time, ESD took significantly longer to perform than the other methods. The histological complete resection rate was 80% (48/60) for cEMR, 85.7% (18/21) for ESD, and 100% (21/21) for ESMR‐L, and the VM positive rate was 20% (12/60) for cEMR, 14.3% (3/21) for ESD, and 0% (0/21) for ESMR‐L, with no significant difference. However, the tumor‐front‐to‐VM distance was significantly longer in the ESMR‐L group than in the cEMR and ESD groups. cEMR and ESD were both significant risk factors for VM positivity. No perforation or local recurrence was observed in all methods. Conclusions ESMR‐L is the most useful ER method for small rectal NETs.

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“…In recent times, studies have reported the efficacy of m-EMR in the treatment of rectal neuroendocrine tumors [16][17][18][19][20][21][22][23][24][25][26]. However, the efficacy and safety of m-EMR versus EMR needs further evaluation.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of modified endoscopic mucosal resection for rectal neuroendocrine tumors: a meta-analysis

Zheng

Zhao

et al. 2020

Z Gastroenterol

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Purpose Rectal neuroendocrine tumors are rare with good prognosis. Several endoscopic methods such as endoscopic polypectomy, endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), and modified endoscopic mucosal resection (m-EMR) are used in the treatment of rectal neuroendocrine tumors. Although m-EMR is derived from traditional EMR, it has not been widely used in clinical practice. In this study, we compared the efficacy and safety of EMR and m-EMR in the treatment of rectal neuroendocrine tumors by performing a meta-analysis. Materials and Methods We searched PubMed, Web of Science, and EMBASE index up to the end of January 2017 for all published literature about EMR and m-EMR in the treatment of rectal neuroendocrine tumors. Results A total of 11 studies involving 811 patients were included. The pooled data suggested that there was a significantly higher rate of histologic complete resection and endoscopic complete resection among patients treated with m-EMR than those treated with EMR (histologic complete resection: OR = 0.23, 95 % CI = 0.10–0.51, p < 0.01; endoscopic complete resection: OR = 0.13, 95 % CI = 0.02–0.74, p = 0.02). The procedure time of EMR was longer than m-EMR (MD = 2.40, 95 % CI = 0.33–4.46, p = 0.02). There was a significantly higher rate of vertical margin involvement among patients treated with EMR than those treated with m-EMR; whereas, there was no significant difference of lateral margin involvement between the m-EMR and EMR groups (vertical margin involvement: OR = 5.00, 95 % CI = 2.67–9.33, p < 0.01; lateral margin involvement: OR = 1.44, 95 % CI = 0.48–4.37, p = 0.52). There was no significant difference in mean tumor size among patients treated with m-EMR versus those treated with EMR (MD = −0.30, 95 % CI = −0.75–0.14, p = 0.18); further, there was no significant difference in endoscopic mean sizes of the tumor and pathological mean sizes of the tumor between the m-EMR and EMR groups (endoscopic mean sizes of the tumor: MD = 0.20, 95 % CI = −0.44–0.84, p = 0.43; pathological mean sizes of the tumor: MD = 0.62, 95 % CI = −0.68–1.92, p = 0.05). No significant differences were detected among the treatment groups with regard to complications (bleeding: OR = 0.87, 95 % CI = 0.39–1.95, p = 0.73; complications (bleeding and perforation): OR = 0.87, 95 % CI = 0.40–1.88, p = 0.73). Conclusion The efficacy of m-EMR are better than EMR among patients undergoing endoscopic treatment of rectal neuroendocrine tumors, and the safety of m-EMR is equivalent to EMR treatment.

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Usefulness of endoscopic resection using the band ligation method for rectal neuroendocrine tumors

Cited by 12 publications

References 32 publications

Treatment Results of Endoscopic Mucosal Resection with a Ligation Device for Duodenal Neuroendocrine Tumors

Treatment Results of Endoscopic Mucosal Resection with a Ligation Device for Duodenal Neuroendocrine Tumors

Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD

Efficacy and safety of modified endoscopic mucosal resection for rectal neuroendocrine tumors: a meta-analysis

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