Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Street, Xi'an, 710004, Shaanxi, China.
Department of Pathology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.
BMC Gastroenterol. 2022 Jun 2;22(1):276. doi: 10.1186/s12876-022-02350-6.
Underwater endoscopic mucosal resection (UMER) is a new method of endoscopic resection to completely remove the lesion without submucosal injection. But few attempts have been carried out for rectal neuroendocrine tumors (rectal NETs).
We retrospectively investigated data on the tumor characteristics and outcomes of patients with ≤ 10 mm rectal NETs who underwent UEMR or endoscopic submucosal dissection (ESD) from January 2019 to June 2021 in our institute.
The endoscopic resection rate was 100% in both UEMR and ESD groups. The histological complete resection rate of the UEMR group (95.5%) was lower than that of the ESD group (96.4%) with no significant difference. The average operation time, hospitalization time and operation cost of UEMR group were less than those of ESD group (P < 0.05). The incidence of postoperative abdominal pain and abdominal distention in the UEMR group was lower than that in the ESD group (P < 0.05). There was no significant difference in the incidence of delayed bleeding and perforation between the two groups. There was no local recurrence or distant metastasis in the two groups during the follow-up period.
Both the UEMR and ESD can effectively treat ≤ 10 mm rectal NETs with invasion depth confined to the mucosa and submucosa. UEMR is superior to ESD in operation time, hospitalization time, operation cost, postoperative abdominal pain and abdominal distention.
水下内镜黏膜切除术（UMER）是一种新的内镜切除方法，可在不进行黏膜下注射的情况下完全切除病变。但对于直肠神经内分泌肿瘤（直肠 NETs），尝试较少。
我们回顾性调查了 2019 年 1 月至 2021 年 6 月在我院接受 UEMR 或内镜黏膜下剥离术（ESD）治疗的 ≤ 10 毫米直肠 NETs 患者的肿瘤特征和结局数据。
UEMR 和 ESD 组的内镜切除率均为 100%。UEMR 组的组织学完全切除率（95.5%）低于 ESD 组（96.4%），但无显著差异。UEMR 组的平均手术时间、住院时间和手术费用均少于 ESD 组（P < 0.05）。UEMR 组术后腹痛和腹胀的发生率低于 ESD 组（P < 0.05）。两组术后迟发性出血和穿孔的发生率无显著差异。两组在随访期间均无局部复发或远处转移。
UEMR 和 ESD 均可有效治疗深度局限于黏膜和黏膜下层的 ≤ 10 毫米直肠 NETs。UEMR 在手术时间、住院时间、手术费用、术后腹痛和腹胀方面优于 ESD。
