Department of Internal Medicine, the Catholic University of Korea College of Medicine, Seoul, Korea.
Dig Endosc. 2014 Jul;26(4):556-63. doi: 10.1111/den.12232. Epub 2014 Jan 22.
We analyzed the characteristics of gastrointestinal neuroendocrine tumors and examined the outcomes and safety of modalities in rectal neuroendocrine tumors.
Between 2007 and 2011, a total of 91 patients with gastrointestinal neuroendocrine tumors were retrospectively reviewed in terms of the characteristics of tumors.
Sixty-six patients had rectal neuroendocrine tumors and underwent endoscopic mucosal resection (EMR, n = 29), endoscopic submucosal dissection (ESD, n = 23), or transanal endoscopic microsurgery (TEM, n = 14). The complete resection rate was higher in the ESD group (82.7%) and in the TEM group (100%) compared to the EMR group (65.5%) (P < 0.046). The complication rate was higher in the ESD group (47.8%) than in the EMR group (18.5%) (P = 0.003). No local tumor recurrence was observed in all patients, regardless of the procedure, during the median follow-up period of 21.5 ± 13.5 months.
ESD achieved a higher complete resection rate than EMR and comparable to TEM. Tumor recurrence was not observed in the endoscopic resection and TEM groups, regardless of the completeness of resection. Small neuroendocrine tumors of the gastrointestinal tract can be managed reliably with both endoscopic resection and TEM.
我们分析了胃肠道神经内分泌肿瘤的特征，并研究了直肠神经内分泌肿瘤的治疗方法的疗效和安全性。
回顾性分析 2007 年至 2011 年间 91 例胃肠道神经内分泌肿瘤患者的肿瘤特征。
66 例直肠神经内分泌肿瘤患者分别接受内镜下黏膜切除术（EMR，n = 29）、内镜黏膜下剥离术（ESD，n = 23）或经肛门内镜微创手术（TEM，n = 14）治疗。ESD 组（82.7%）和 TEM 组（100%）的完全切除率均高于 EMR 组（65.5%）（P < 0.046）。ESD 组（47.8%）的并发症发生率高于 EMR 组（18.5%）（P = 0.003）。在中位随访 21.5 ± 13.5 个月期间，所有患者（无论采用何种治疗方法）均未观察到局部肿瘤复发。
ESD 组的完全切除率高于 EMR 组，与 TEM 组相当。在 EMR 和 TEM 组中，无论肿瘤切除的完整性如何，均未观察到肿瘤复发。胃肠道小的神经内分泌肿瘤可以通过内镜下切除和 TEM 可靠地治疗。
