Zhang Zefeng, Liu Chao
Department of Digestive Endoscopy Center, Guangdong Provincial Peolple's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Second Road, Guangzhou, 510080, Guangdong, People's Republic of China.
Department of Pathology, Guangdong Provincial Peolple's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, Guangdong, People's Republic of China.
Discov Oncol. 2025 Feb 28;16(1):251. doi: 10.1007/s12672-025-01886-9.
The objective of this study was to evaluate the effectiveness and safety of endoscopic mucosal resection assisted by a transparent cap (EMR-C) for rectal neuroendocrine tumor (R-NET) by novice endoscopists of digestive endoscopy center.
R-NET patients consulted in department of digestive endoscopy center of Guangdong Provincial Peolple's Hospital from 2022 to 2023, were recruited in this study. Novice endoscopists who had no ESD experience before were randomly to accomplish the EMR-C operation. Each novice endoscopist separately completed at least 3 cases after simple training by teachers and the operation time was counted on average. Vertical and horizontal margins of the specimens were further analyzed to determine whether radical resection was successful or not. R-NET patients were followed up at 12 months after operation.
30 cases of R-NET patients (13 males and 17 females, (53.83 ± 13.31) y), originated from the deep or submucosal layers of the intestinal wall mucosa by ultrasound colonoscopy, were recruited in all of our study. 10 novice endoscopists (each for 3 cases) were arranged to complete EMR-C operations by 2 teachers. The average time was (8.87 ± 1.87) minutes and the sections were clean and no bleeding and further clipped by 2-4 metal clips. Pathological and immunohistochemical results were further made to confirm the diagnosis. The en bloc resection rate was 100.00% and the R0 rate was 83.33% (horizontal margins were 100.00% negative and the vertical margins were 83.33% negative). No recurrence was found during the followed up at 12 months after operation.
EMR-C is safe and efficient for R-NET, and easily manageable for novice endoscopists of digestive endoscopy center.
本研究旨在评估消化内镜中心的新手内镜医师采用透明帽辅助内镜黏膜切除术（EMR-C）治疗直肠神经内分泌肿瘤（R-NET）的有效性和安全性。
招募2022年至2023年在广东省人民医院消化内镜中心就诊的R-NET患者。将之前无内镜黏膜下剥离术（ESD）经验的新手内镜医师随机安排完成EMR-C手术。每位新手内镜医师在教师简单培训后分别至少完成3例手术，并计算平均手术时间。进一步分析标本的垂直和水平切缘，以确定根治性切除是否成功。R-NET患者术后12个月进行随访。
本研究共纳入30例R-NET患者（男13例，女17例，年龄（53.83±13.31）岁），经超声结肠镜检查显示肿瘤起源于肠壁黏膜深层或黏膜下层。安排10名新手内镜医师（每人3例）由2名教师指导完成EMR-C手术。平均手术时间为（8.87±1.87）分钟，切除部位干净，无出血，并用2-4枚金属夹进一步夹闭。进一步进行病理及免疫组化结果以确诊。整块切除率为100.00%，R0切除率为83.33%（水平切缘阴性率为100.00%，垂直切缘阴性率为83.33%）。术后12个月随访未发现复发。
EMR-C治疗R-NET安全有效，对于消化内镜中心的新手内镜医师易于操作。
