Underwater Endoscopic Mucosal Resection of Small Rectal Neuroendocrine Tumors

Okada, Masahiro; Shinozaki, Satoshi; Ikeda, Etsuko; Hayashi, Yoshikazu; Takezawa, Takahito; Fukuda, Hisashi; Morikawa, Takaaki; Kitamura, Mitsunobu; Arita, Munefumi; Nomura, Tatsuma; Sakamoto, Hirotsugu; Sunada, Keijiro; Fukushima, Noriyoshi; Lefor, Alan Kawarai; Yamamoto, Hironori

doi:10.3389/fmed.2022.835013

Cited by 3 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, the choice of optimal treatment, even for salvage procedures, remains a subject of clinical debate [5,13]. Traditional endoscopic polypectomy is not typically recommended for RNET resections because it usually does not achieve adequate and complete lesion removal and may necessitate additional interventions [6,13,20]. Anatomical alterations caused by previous interventions often damage rectal layers, complicating the use of lifting techniques or other adjunctive methods and potentially leading to further complications.…”

Section: Discussionmentioning

confidence: 99%

Analysis of endoscopic salvage treatment of rectal neuroendocrine tumor; effective utilization of polypectomy

Ju,

Bong,

Cheong

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Current guidelines recommend endoscopic resection for rectal neuroendocrine tumors (RNETs) under 10 mm. Incomplete resections necessitate salvage procedures, highlighting the need for complete R0 resection. This study assesses the efficacy and safety of wide hot snare polypectomy (WHSP) compared to endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for treating small RNETs. Methods This retrospective study was conducted at Korea University Guro Hospital from January 2018 to December 2022. It compared the outcomes of salvage resections for RNETs ≤ 10 mm using two approaches: endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) versus WHSP. Demographics, tumor characteristics, and clinical outcomes were compared. Efficacy was evaluated by the histological complete resection rate and procedure time, while safety was assessed by the incidence of complications. Results Out of 135 patients undergoing salvage resection for RNET, 14 who underwent transanal excision were excluded. Of the remaining 121, 99 underwent EMR or ESD, and 22 underwent WHSP. Baseline characteristics were similar between the two groups. The WHSP group demonstrated a significantly higher R0 resection rate (72.7% vs. 49.5%, p = 0.010) and a shorter median procedure time (3.5 min vs. 8.3 min). No complications were reported in the WHSP group. Conclusion Wide hot snare polypectomy is a rapid, straightforward, safe, and effective approach for the salvage treatment of rectal neuroendocrine tumors (RNETs) less than 10 mm in diameter, particularly in patients without additional risk factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Analysis of endoscopic salvage treatment of rectal neuroendocrine tumor; effective utilization of polypectomy

Ju,

Bong,

Cheong

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Nevertheless, EMR had a shorter procedure time and a similarly lower recurrence rate than ESD. Additionally, owing to the advantages of operation convenience, fewer skill requirements for surgeons, lower medical costs, and availability in day surgery, 42 – 44 EMR is superior to ESD in treating rectal NETs no larger than 10 mm from the perspective of health economics.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of endoscopic mucosal resection versus endoscopic submucosal dissection for rectal neuroendocrine tumors ≤10mm: a systematic review and meta-analysis

Zhou

Zhang

2023

Ann Saudi Med

View full text Add to dashboard Cite

BACKGROUND: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are surgical methods used for rectal neuroendocrine tumors (NETs) with diameters of ≤ 10 mm. However, which method has a higher performance remains uncertain. OBJECTIVES: Evaluate which of the two methods shows a higher performance. DESIGN: Systematic review and meta-analysis METHODS: Data from PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to 12 April 2022. Outcomes, including complete resection, en bloc resection, recurrence, perforation, bleeding, and procedure time, were pooled by 95% confidence intervals (95% CI) using a fixed- or random-effects model. MAIN OUTCOME MEASURES: Complete resection, en bloc resection, and recurrence. SAMPLE SIZE: 18 studies, including 1168 patients were included in the study. RESULTS: Eighteen retrospective cohort studies were included in this meta-analysis. There were no statistical differences in the rates of complete resection, en bloc resection, recurrence, perforation, and bleeding rates between EMR and ESD. However, a statistical difference was detected in the procedure time; EMR had a significantly shorter time (MD=−17.47, 95% CI=−22.31 – −12.62, P <.00001). CONCLUSIONS: EMR and ESD had similar efficacies and safety profiles in resectioning rectal NETs ≤ 10 mm. Even so, the advantages of EMR included a shorter operation time and expenditure. Thus, with respect to health economics, EMR outperformed ESD. LIMITATION: Most of these studies are retrospective cohort studies instead of RCTs. CONFLICT OF INTEREST: None.

show abstract

“…This study achieved 100% en bloc resection and R0 resection rates in both groups, with two adverse events in the ESMR-L group and no adverse events in the UEMR group. 29 A summary of comparative studies of UEMR with other endoscopic tech-niques for resection of rNETs is shown in Table 3. 5,9,29…”

Section: Uemr In Rectal Netsmentioning

confidence: 99%

Underwater Resection of Neuroendocrine Tumors of the Gastrointestinal Tract: A Systematic Review

do Espirito Santo,

de Souza,

Silva

et al. 2023

J Transl Gastroenterol

View full text Add to dashboard Cite

Background and objectives: Over the past decade, the approach to gastrointestinal (GI) neuroendocrine tumors (NETs) has increasingly included endoscopic resection (ER) techniques. Underwater endoscopic mucosal resection (UEMR) has been introduced as a potential alternative to conventional mucosectomy. The objective of this systematic review is to investigate the feasibility and outcomes of UEMR in the treatment of GI NETs and to provide a reference for clinical management options. Methods:A systematic search of PubMed, Cochrane Library, and EMBASE was performed to identify guidelines and primary literature published up to 8 August 2023.Results: Our review did not find any UEMR results for esophageal NETs. For gastric NETs, there is only one case series pilot study with two patients with G1 tumors, that were completely resected without complications. For duodenal NETs eligible for ER, a total of 11 cases are reported, with success in all procedures. For ileum NETs, there is only one report, for an outlier case. Finally, UEMR is best indicated for rectal tumors, where it is an alternative to endoscopic mucosal resection or endoscopic submucosal dissection techniques, as shown in four comparative studies.Conclusions: UEMR is presented as a good option for selected cases, as it has notable advantages in that it can achieve a complete histological resection at a lower cost, with a short procedure time, and does not require advanced endoscopic skills to ensure good results.

show abstract

Underwater Endoscopic Mucosal Resection of Small Rectal Neuroendocrine Tumors

Cited by 3 publications

References 8 publications

Analysis of endoscopic salvage treatment of rectal neuroendocrine tumor; effective utilization of polypectomy

Analysis of endoscopic salvage treatment of rectal neuroendocrine tumor; effective utilization of polypectomy

Efficacy of endoscopic mucosal resection versus endoscopic submucosal dissection for rectal neuroendocrine tumors ≤10mm: a systematic review and meta-analysis

Underwater Resection of Neuroendocrine Tumors of the Gastrointestinal Tract: A Systematic Review

Contact Info

Product

Resources

About