KMID : 1038120170500060585
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Clinical Endoscopy 2017 Volume.50 No. 6 p.585 ~ p.591
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Efficacy of Precut Endoscopic Mucosal Resection for Treatment of Rectal Neuroendocrine Tumors
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So Hoon-Sub
Yoo Su-Hyun Han Seung-Bong Kim Gwang-Un Seo Myeong-Sook Hwang Sung-Wook Yang Dong-Hoon Byeon Jeong-Sik
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Abstract
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Background/Aims: Endoscopic resection is the first-line treatment for rectal neuroendocrine tumors (NETs) measuring <1 cm and those between 1 and 2 cm in size. However, conventional endoscopic resection cannot achieve complete resection in all cases. We aimed to analyze clinical outcomes of precut endoscopic mucosal resection (EMR-P) used for the management of rectal NET.
Methods: EMR-P was used to treat rectal NET in 72 patients at a single tertiary center between 2011 and 2015. Both, circumferential precutting and EMR were performed with the same snare device in all patients. Demographics, procedural details, and histopathological features were reviewed for all cases.
Results: Mean size of the tumor measured endoscopically was 6.8¡¾2.8 mm. En bloc and complete resection was achieved in 71 (98.6%) and 67 patients (93.1%), respectively. The mean time required for resection was 9.0¡¾5.6 min. Immediate and delayed bleeding developed in six (8.3%) and 4 patients (5.6%), respectively. Immediate bleeding observed during EMR-P was associated with the risk of delayed bleeding.
Conclusions: Both, the en bloc and complete resection rates of EMR-P in the treatment of rectal NETs using the same snare for precutting and EMR were noted to be high. The procedure was short and safe. EMR-P may be a good treatment choice for the management of rectal NETs.
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KEYWORD
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Rectum, Carcinoid tumor, Neuroendocrine tumors, Endoscopic mucosal resection
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