Comparison of efficacy between endoscopic submucosal dissection and modified-endoscopic mucosal resection for G1 rectal neuroendocrine tumors
10.3760/cma.j.cn321463-20231211-00135
- VernacularTitle:内镜黏膜下剥离术与改良内镜黏膜切除术对G1期直肠神经内分泌瘤的疗效对比分析
- Author:
Ting ZHOU
1
;
Lei WANG
;
Guifang XU
;
Xiaotan DOU
;
Dehua TANG
;
Muhan NI
;
Peng YAN
;
Jinyan LIU
;
Yun HU
Author Information
1. 南京大学医学院附属鼓楼医院消化科，南京 210008
- Keywords:
Rectal neoplasms;
Neuroendocrine tumors;
Endoscopic submucosal dissection;
Modified-endoscopic mucosal resection;
Inverse probability of treatment weighti
- From:
Chinese Journal of Digestive Endoscopy
2024;41(8):619-625
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of endoscopic submucosal dissection (ESD) and modified-endoscopic mucosal resection (M-EMR) for G1 rectal neuroendocrine tumors (RNETs) .Methods:Data of 121 patients with pathologically confirmed G1 RNETs treated with ESD ( n=105) or M-EMR ( n=16) in Nanjing Drum Tower Hospital from January 2017 to September 2020 were retrospectively analyzed. The complete resection rate, complication incidence, hospital stay, treatment cost and other indicators of the two groups were compared by using inverse probability of treatment weighting (IPTW). Results:There were significant differences in tumor number ( χ2=8.76, P=0.003), tumor invasion depth ( χ2=6.96, P=0.008), utilization of metal clips [82.9% (87/105) VS 93.8% (15/16), χ2=8.78, P=0.003], number of metal clips ( χ2=8.41, P=0.016), hemostasis using hot clamp [78.1% (82/105) VS 18.7% (3/16), χ2=20.64, P<0.001], traction procedure [2.9% (3/105) VS 18.7% (3/16), χ2=4.45, P=0.035] and treatment cost (17 568.6 ± 8 911.0 yuan VS 8 120.8±1 528.2 yuan, t=3.65, P<0.001) between the ESD group and the M-EMR group. After verifying the stability of the results using IPTW sensitivity analysis, there was still significant difference in the treatment cost ( t=2.07, P<0.001). Conclusion:Both ESD and M-EMR demonstrate comparable efficacy in treating G1 RNETs; however, M-EMR exhibites lower treatment costs.
