Efficacy and safety of hybrid endoscopic submucosal dissection compared with endoscopic submucosal dissection for rectal neuroendocrine tumors and risk factors associated with incomplete endoscopic resection

被引:30
作者
Wang, Xiang-Yao [1 ]
Chai, Ning-Li [1 ]
Linghu, En-Qiang [1 ]
Li, Hui-Kai [1 ]
Zhai, Ya-Qi [1 ]
Feng, Xiu-Xue [1 ]
Zhang, Wen-Gang [1 ]
Zou, Jia-Le [1 ]
Li, Long-Song [1 ]
Xiang, Jing-Yuan [1 ]
机构
[1] Chinese Peoples Liberat Army Gen Hosp, Dept Gastroenterol & Hepatol, 28 Fuxing Rd, Beijing 100853, Peoples R China
基金
国家重点研发计划;
关键词
Endoscopic submucosal dissection (ESD); hybrid endoscopic submucosal dissection (hybrid ESD); rectal neuroendocrine tumors (NETs); endoscopic resection (ER); CLINICAL-OUTCOMES; COLORECTAL TUMORS; CARCINOID-TUMORS; MANAGEMENT;
D O I
10.21037/atm.2020.02.25
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Neuroendocrine tumors (NETs) are rising in prevalence, particularly with the rectal area. This study evaluated and compared the safety and effectiveness of hybrid endoscopic submucosal dissection (ESD) with those of ESD for rectal NETs and risk factors associated with incomplete endoscopic resection. Methods: A total of 272 consecutive patients who underwent ESD or hybrid ESD for rectal NF, Ts at the Chinese PLA General Hospital in the period from February 2011 to September 2018 were involved in this study. Data were collected from clinical and endoscopic databases. The procedure time, en bloc resection, complete resection, complication, and recurrence rates were evaluated. Results: In the hybrid ESD group were 111 patients (who had 119 lesions between them), with a further 161 patients (164 lesions) in the ESD group. No significance was found in baseline characteristics between the two groups. Hybrid ESD had a significantly shorter mean procedure time than ESD (13.2 +/- 8.3 vs. 18.1 +/- 9.7 min, P=0.000). Hybrid ESD showed similar en bloc resection (99.2% vs. 98.2%; P=0.373), complete resection (94.1% vs. 90.9%, P=0.641), and postprocedural bleeding (2.5% vs. 0.6%, P=0.313) rates to ESD. Univariate and multivariate analysis showed that higher histopathological grade was associated with incomplete resection. Conclusions: For rectal NET, both ESD and hybrid ESD are effective and safe forms of treatment. Hybrid ESD provides an alternative option in the treatment of rectal NETs. Further developments arc needed to improve the complete resection rate, especially concerning tumors with higher histopathological grade.
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页数:11
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