Comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors: A multicenter retrospective study

Abstract Objectives Endoscopic submucosal resection with band ligation (ESMR‐L) and endoscopic submucosal dissection (ESD) are both standard endoscopic resection methods for rectal neuroendocrine tumors (NETs) <10 mm in size. However, there is no definitive consensus on which is better. Here, we...

Full description

Saved in:
Bibliographic Details
Main Authors: Kenshi Matsuno, Hideaki Miyamoto, Hideki Kitada, Shinichi Yoshimatsu, Fumio Tamura, Kouichi Sakurai, Kotaro Fukubayashi, Takashi Shono, Hiroko Setoyama, Taichi Matsuyama, Shinichiro Suko, Rei Narita, Munenori Honda, Masakuni Tateyama, Hideaki Naoe, Jun Morinaga, Yasuhito Tanaka, Ryosuke Gushima
Format: Article
Language:English
Published: Wiley 2023-04-01
Series:DEN Open
Subjects:
Online Access:https://doi.org/10.1002/deo2.163
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850276386559754240
author Kenshi Matsuno
Hideaki Miyamoto
Hideki Kitada
Shinichi Yoshimatsu
Fumio Tamura
Kouichi Sakurai
Kotaro Fukubayashi
Takashi Shono
Hiroko Setoyama
Taichi Matsuyama
Shinichiro Suko
Rei Narita
Munenori Honda
Masakuni Tateyama
Hideaki Naoe
Jun Morinaga
Yasuhito Tanaka
Ryosuke Gushima
author_facet Kenshi Matsuno
Hideaki Miyamoto
Hideki Kitada
Shinichi Yoshimatsu
Fumio Tamura
Kouichi Sakurai
Kotaro Fukubayashi
Takashi Shono
Hiroko Setoyama
Taichi Matsuyama
Shinichiro Suko
Rei Narita
Munenori Honda
Masakuni Tateyama
Hideaki Naoe
Jun Morinaga
Yasuhito Tanaka
Ryosuke Gushima
author_sort Kenshi Matsuno
collection DOAJ
description Abstract Objectives Endoscopic submucosal resection with band ligation (ESMR‐L) and endoscopic submucosal dissection (ESD) are both standard endoscopic resection methods for rectal neuroendocrine tumors (NETs) <10 mm in size. However, there is no definitive consensus on which is better. Here, we compared the efficacy of ESMR‐L and ESD for small rectal NETs. Methods This was a multicenter retrospective cohort study including 205 patients with rectal NETs who underwent ESMR‐L or ESD. Treatment outcomes were compared by univariate analysis, multivariate analysis, and inverse probability treatment weighting (IPTW) using propensity scores. Subgroup analysis evaluated the impact of the endoscopist's experience on the technical outcome. Results Eighty‐nine patients were treated by ESMR‐L and 116 by ESD. The R0 resection rate was not significantly different between the two (90% vs. 92%, p = 0.73). The procedure time of ESMR‐L was significantly shorter than for ESD (17 min vs. 52 min, p < 0.01) and the hospitalization period was also significantly shorter (3 days vs. 5 days, p < 0.01). These results were confirmed by multivariate analysis and also after IPTW adjustment. The procedure time of ESD was significantly prolonged by a less‐experienced endoscopist (49 min vs. 70 min, p = 0.02), but that of ESMR‐L was not affected (17 min vs. 17 min, p = 0.27). Conclusions For small rectal NETs, both ESMR‐L and ESD showed similar high complete resection rates. However, considering the shorter procedure time and shorter hospitalization period, ESMR‐L is the more efficient treatment method, especially for less‐experienced endoscopists.
format Article
id doaj-art-11ff21f9f0f84bca8537b81da6250e2b
institution OA Journals
issn 2692-4609
language English
publishDate 2023-04-01
publisher Wiley
record_format Article
series DEN Open
spelling doaj-art-11ff21f9f0f84bca8537b81da6250e2b2025-08-20T01:50:18ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.163Comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors: A multicenter retrospective studyKenshi Matsuno0Hideaki Miyamoto1Hideki Kitada2Shinichi Yoshimatsu3Fumio Tamura4Kouichi Sakurai5Kotaro Fukubayashi6Takashi Shono7Hiroko Setoyama8Taichi Matsuyama9Shinichiro Suko10Rei Narita11Munenori Honda12Masakuni Tateyama13Hideaki Naoe14Jun Morinaga15Yasuhito Tanaka16Ryosuke Gushima17Department of Gastroenterology and Hepatology Faculty of Life Sciences Kumamoto University Kumamoto JapanDepartment of Gastroenterology and Hepatology Faculty of Life Sciences Kumamoto University Kumamoto JapanDepartment of Gastroenterology Japanese Red Cross Kumamoto Hospital Kumamoto JapanDepartment of Gastroenterology Kumamoto General Hospital Community Health Care Organization Kumamoto JapanDepartment of Gastroenterology Kumamoto Regional Medical Center Kumamoto JapanHattori Clinic Kumamoto JapanDepartment of Gastroenterology Tamana Central Hospital Kumamoto JapanDepartment of Gastroenterology Kumamoto Chuo Hospital Kumamoto JapanDepartment of Gastroenterology and Hepatology Faculty of Life Sciences Kumamoto University Kumamoto JapanDepartment of Gastroenterology National Hospital Organization Kumamoto Medical Center Kumamoto JapanDepartment of Gastroenterology Saiseikai Kumamoto Hospital Kumamoto JapanDepartment of Gastroenterology Minamata City Hospital and Medical Center Kumamoto JapanDepartment of Gastroenterology and Hepatology Faculty of Life Sciences Kumamoto University Kumamoto JapanDepartment of Gastroenterology and Hepatology Faculty of Life Sciences Kumamoto University Kumamoto JapanDepartment of Gastroenterology and Hepatology Faculty of Life Sciences Kumamoto University Kumamoto JapanDepartment of Clinical Investigation (Biostatistics) Kumamoto University Hospital Kumamoto JapanDepartment of Gastroenterology and Hepatology Faculty of Life Sciences Kumamoto University Kumamoto JapanDepartment of Gastroenterology and Hepatology Faculty of Life Sciences Kumamoto University Kumamoto JapanAbstract Objectives Endoscopic submucosal resection with band ligation (ESMR‐L) and endoscopic submucosal dissection (ESD) are both standard endoscopic resection methods for rectal neuroendocrine tumors (NETs) <10 mm in size. However, there is no definitive consensus on which is better. Here, we compared the efficacy of ESMR‐L and ESD for small rectal NETs. Methods This was a multicenter retrospective cohort study including 205 patients with rectal NETs who underwent ESMR‐L or ESD. Treatment outcomes were compared by univariate analysis, multivariate analysis, and inverse probability treatment weighting (IPTW) using propensity scores. Subgroup analysis evaluated the impact of the endoscopist's experience on the technical outcome. Results Eighty‐nine patients were treated by ESMR‐L and 116 by ESD. The R0 resection rate was not significantly different between the two (90% vs. 92%, p = 0.73). The procedure time of ESMR‐L was significantly shorter than for ESD (17 min vs. 52 min, p < 0.01) and the hospitalization period was also significantly shorter (3 days vs. 5 days, p < 0.01). These results were confirmed by multivariate analysis and also after IPTW adjustment. The procedure time of ESD was significantly prolonged by a less‐experienced endoscopist (49 min vs. 70 min, p = 0.02), but that of ESMR‐L was not affected (17 min vs. 17 min, p = 0.27). Conclusions For small rectal NETs, both ESMR‐L and ESD showed similar high complete resection rates. However, considering the shorter procedure time and shorter hospitalization period, ESMR‐L is the more efficient treatment method, especially for less‐experienced endoscopists.https://doi.org/10.1002/deo2.163colonoscopyendoscopic resectionendoscopic submucosal dissectionendoscopic submucosal resection with band ligationrectal neuroendocrine tumors
spellingShingle Kenshi Matsuno
Hideaki Miyamoto
Hideki Kitada
Shinichi Yoshimatsu
Fumio Tamura
Kouichi Sakurai
Kotaro Fukubayashi
Takashi Shono
Hiroko Setoyama
Taichi Matsuyama
Shinichiro Suko
Rei Narita
Munenori Honda
Masakuni Tateyama
Hideaki Naoe
Jun Morinaga
Yasuhito Tanaka
Ryosuke Gushima
Comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors: A multicenter retrospective study
DEN Open
colonoscopy
endoscopic resection
endoscopic submucosal dissection
endoscopic submucosal resection with band ligation
rectal neuroendocrine tumors
title Comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors: A multicenter retrospective study
title_full Comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors: A multicenter retrospective study
title_fullStr Comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors: A multicenter retrospective study
title_full_unstemmed Comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors: A multicenter retrospective study
title_short Comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors: A multicenter retrospective study
title_sort comparison of endoscopic submucosal resection with ligation and endoscopic submucosal dissection for small rectal neuroendocrine tumors a multicenter retrospective study
topic colonoscopy
endoscopic resection
endoscopic submucosal dissection
endoscopic submucosal resection with band ligation
rectal neuroendocrine tumors
url https://doi.org/10.1002/deo2.163
work_keys_str_mv AT kenshimatsuno comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT hideakimiyamoto comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT hidekikitada comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT shinichiyoshimatsu comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT fumiotamura comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT kouichisakurai comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT kotarofukubayashi comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT takashishono comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT hirokosetoyama comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT taichimatsuyama comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT shinichirosuko comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT reinarita comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT munenorihonda comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT masakunitateyama comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT hideakinaoe comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT junmorinaga comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT yasuhitotanaka comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy
AT ryosukegushima comparisonofendoscopicsubmucosalresectionwithligationandendoscopicsubmucosaldissectionforsmallrectalneuroendocrinetumorsamulticenterretrospectivestudy