Hawa Fadi, Sako Zeyad, Nguyen Than, Catanzaro Andrew T, Zolotarevsky Eugene, Bartley Angela N, Gunaratnam Naresh T
Department of Internal Medicine, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, Michigan, United States.
Department of Hematology and Oncology, Ascension St. John Hospital, Detroit, Michigan, United States.
Endosc Int Open. 2020 Jun;8(6):E717-E721. doi: 10.1055/a-1119-6698. Epub 2020 May 25.
Endoscopic resection is recommended as initial treatment for early-stage gastric and duodenal neuroendocrine tumors (G-NETs and D-NETs). However, it can cause serious adverse events. We aimed to evaluate the efficacy and safety of the band and slough (BAS) technique as a novel and less aggressive endoscopic therapy for management of such tumors. Four patients, three diagnosed with < 10-mm D-NET and one with 10-mm type I G-NET, were treated with the BAS technique without endoscopic resection. Initial follow-up endoscopy at 3 months was done to assess for residual tumor. Subsequent endoscopic surveillance was performed. After one session of banding, all patients achieved complete remission at 3-month follow-up. No tumor recurrence was detected on repeat biopsy at 12-month surveillance endoscopy. None of the patients developed any adverse events including bleeding or perforation. The BAS technique may prove to be a safe and effective endoscopic therapy for diminutive, non-metastatic type 1 G-NETs and D-NETs. Studies of larger scale and longer follow-up periods are needed to corroborate these findings.
内镜切除术被推荐作为早期胃和十二指肠神经内分泌肿瘤（G-NETs和D-NETs）的初始治疗方法。然而，它可能会导致严重的不良事件。我们旨在评估套扎与脱痂（BAS）技术作为一种新型且侵入性较小的内镜治疗方法来管理这类肿瘤的疗效和安全性。4例患者，3例诊断为直径<10mm的D-NET，1例诊断为直径10mm的I型G-NET，接受了BAS技术治疗，未进行内镜切除术。在3个月时进行了首次随访内镜检查以评估残留肿瘤情况。随后进行了内镜监测。在一次套扎治疗后，所有患者在3个月随访时均实现完全缓解。在12个月监测内镜检查时重复活检未发现肿瘤复发。所有患者均未出现任何不良事件，包括出血或穿孔。BAS技术可能被证明是一种用于微小、非转移性I型G-NETs和D-NETs的安全有效的内镜治疗方法。需要进行更大规模和更长随访期的研究来证实这些发现。
