Application of C-type incision to endoscopic submucosal dissection for the treatment of rectal neuroendocrine tumors
10.3760/cma.j.cn321463-20211230-00577
- VernacularTitle:C型切开法内镜黏膜下剥离术在直肠神经内分泌肿瘤中的应用研究
- Author:
Qiuli WU
1
;
Huaiying SU
;
Shuying LIN
;
Rensong HE
;
Xiangbo CHEN
Author Information
1. 福建省泉州市第一医院内窥镜室，泉州 362000
- Keywords:
Neuroendocrine tumors;
Rectum;
Endoscopic submucosal dissection;
C-type incision
- From:
Chinese Journal of Digestive Endoscopy
2023;40(1):53-57
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical efficacy of C-type endoscopic submucosal dissection (C-ESD) for rectal neuroendocrine tumors (NEN).Methods:The retrospective analysis was performed on data of 55 patients who underwent ESD for rectal NEN at the Department of Endoscopy in Quanzhou First Hospital from January 2018 to July 2021. Patients were divided into the C-ESD group ( n=28) and the conventional ESD group ( n=27). The dissection time, the dissection speed, the number of submucosal injections, the enbloc resection rate, the curative resection rate and the rate of postoperative complications of the two groups were compared. Results:There were no statistically significant differences in basic information between the two groups ( P>0.05). The dissection time was 13.8±4.2 min in the C-ESD group and 19.9±3.9 min in the conventional ESD group with statistically significant difference ( t=5.649, P<0.001). The dissection speed in the C-ESD group was 0.08±0.04 cm 2/min, which was faster than 0.06±0.04 cm 2/min in the conventional ESD group ( t=2.218, P=0.031). The number of submucosal injections in the C-ESD group was less than that in the conventional ESD group [2 (1, 2) VS 3 (2, 3), Z=-8.701, P<0.001]. The lesions were enbloc resected in both groups. The curative resection rate in the C-ESD group was 100.0% (28/28) and 88.9% (24/27) in the conventional ESD group with statistically significant difference ( P=0.011). There were 7 cases of postoperative complications in the conventional ESD group, including 1 delayed bleeding, 5 delayed perforation and 1 muscularis propria injury, while no postoperative complications occurred in the C-ESD group ( P=0.004). Conclusion:C-ESD is a safe and effective treatment strategy for colorectal NEN, which can shorten the dissection time, improve the dissection speed, reduce the number of submucosal injections, improve the curative resection rate, and reduce complications.
