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内镜黏膜下切除术与内镜黏膜下剥离术治疗直肠神经内分泌肿瘤的比较。

Comparison between endoscopic mucosal resection with a cap and endoscopic submucosal dissection for rectal neuroendocrine tumors.

机构信息

Department of Endoscopy, The Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Chang 'an District, Shijiazhuang, 050000, Hebei, China.

Department of Gastroenterology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Chang 'an District, Shijiazhuang, 050000, Hebei, China.

出版信息

BMC Surg. 2022 Jun 27;22(1):248. doi: 10.1186/s12893-022-01693-x.

Abstract

BACKGROUND

The aim of this study is to evaluate and compare the safety and efficacy of endoscopic mucosal resection with a cap (EMR-c) with those of endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors (R-NETs) ≤ 15 mm in diameter, and to analyze the risk factors of incomplete resection.

METHODS

A total of 122 patients who underwent EMR-c or ESD for R-NETs at the Fourth Hospital of Hebei Medical University between February 2007 and December 2020 were invovled in this study. The clinical outcomes of two groups were compared and evaluated.

RESULTS

A total of 122 patients with 128 R-NETs underwent endoscopic resection (EMR-c, 80; ESD, 48). In terms of duration of operation, EMR-c was significantly shorter than ESD (p < 0.001). Univariate analysis and multivariate analysis suggested that tumor diameter ≥ 8 mm was an independent risk factor for incomplete resection in patients with R-NETs in this study.

CONCLUSIONS

Both EMR-c and ESD were safe and effective treatments for R-NETs ≤ 15 mm in diameter. In addition, tumor diameter ≥ 8 mm was an independent risk factor for incomplete resection.

摘要

背景

本研究旨在评估和比较内镜黏膜切除术加帽(EMR-c)与内镜黏膜下剥离术(ESD)治疗直径≤15mm 的直肠神经内分泌肿瘤(R-NETs)的安全性和疗效,并分析切缘阳性的危险因素。

方法

本研究共纳入 2007 年 2 月至 2020 年 12 月在河北医科大学第四医院接受 EMR-c 或 ESD 治疗的 122 例 R-NETs 患者。比较两组患者的临床转归。

结果

共 122 例患者的 128 个 R-NETs 接受了内镜切除(EMR-c,80 例;ESD,48 例)。在手术时间方面,EMR-c 明显短于 ESD(p<0.001)。单因素分析和多因素分析提示,肿瘤直径≥8mm 是本研究中 R-NETs 患者内镜下切缘阳性的独立危险因素。

结论

EMR-c 和 ESD 均是治疗直径≤15mm 的 R-NETs 的安全有效的方法。此外,肿瘤直径≥8mm 是内镜下切缘阳性的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bff0/9238094/ee03363eb234/12893_2022_1693_Fig1_HTML.jpg

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