Endoscopic full-thickness resection:A definitive solution for local complete resection of small rectal neuroendocrine neoplasms  

作　　者：Xiao-Long Zhang Yang-Yang Jiang Ying-Ying Chang Yu-Li Sun Ying Zhou Yao-Hui Wang Xiao-Tan Dou Hui-Min Guo Ting-Sheng Ling 

机构地区：[1]Digestive Endoscopy Center,Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,Jiangsu Province,China [2]Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu Province,China [3]Department of Pathology,Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,Jiangsu Province,China [4]Department of Gastroenterology,Nanjing Drum Tower Hospital,Nanjing 210008,Jiangsu Province,China

出　　处：《World Journal of Gastroenterology》2025年第10期51-61,共11页世界胃肠病学杂志(英文)

基　　金：Supported by National Natural Science Foundation of China,No.82004298;Jiangsu Graduate Research and Practice Innovation Program,China,No.KYCX23_2090.

摘　　要：BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particularly in the vertical direction.Endoscopic full-thickness resection(EFTR)has proven to be an effective method for the treatment of submucosal tumors but is seldom utilized in the eradication of R-NENs.AIM To review cases of R-NENs removed using EFTR and to evaluate the safety and efficacy of this technique.METHODS This retrospective cohort study enrolled 160 patients with pathologically confirmed R-NENs,including 132 who underwent endoscopic submucosal dissection(ESD)and 28 who underwent EFTR.Lesions were categorized as<1 cm,1-2 cm,and>2 cm in size.CR rate,en bloc resection rate,operation time,and complications were evaluated.Subgroup analyses and follow-up were also performed.RESULTS EFTR achieved 100%CR rates for lesions<1 cm and 1-2 cm,compared with 67.0%and 50.0%,respectively,in the ESD group.En bloc resection and successful removal of the R-NENs were achieved in all patients.Meanwhile,EFTR showed performance comparable to ESD in terms of operation time,hospitalization cost,and postoperative adverse events,except for a one-day longer hospital stay.We also analyzed the invasion depth of R-NENs based on full-thickness specimens.The data showed that 80%of lesions(<1 cm)and 85.7%of lesions(1-2 cm)had invaded the SM3 level or deeper at the time of resection.For ESD specimens,46.6%(<1 cm)and 89.3%(1-2 cm)of lesions had infiltrated more than 2000μm beneath the muscularis mucosae.CONCLUSION EFTR has shown superior performance in the resection of small R-NENs compared with that of ESD.

关 键 词：Endoscopic full-thickness resection Endoscopic submucosal dissection Rectal neuroendocrine neoplasms Complete resection Endoscopic technique 

分 类 号：R73[医药卫生—肿瘤]