Risk factors for inadequate vertical margin in endoscopic resection of small rectal neuroendocrine tumors
10.3760/cma.j.cn321463-20240812-00357
- VernacularTitle:内镜切除治疗直肠小神经内分泌肿瘤垂直切缘不充分的危险因素研究
- Author:
Jianning LIU
1
;
Lihong GAN
;
Peng LIU
;
Hui LIU
;
Kaige ZHANG
;
Qi FENG
;
Ling YAO
;
Gen HUANG
;
Nian FANG
Author Information
1. 南昌大学玛丽女王学院，南昌 330031
- Publication Type:Journal Article
- Keywords:
Neuroendocrine tumors;
Rectum;
Endoscopic mucosal resection;
Margins of excision;
Risk factors
- From:
Chinese Journal of Digestive Endoscopy
2025;42(3):202-206
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify risk factors influencing clinical efficacy of endoscopic resection of small rectal neuroendocrine tumor (NETs).Methods:A retrospective analysis was conducted on patients with rectal NETs ≤10 mm who underwent endoscopic resection from 2013 to 2022. Patients were divided into the endoscopic submucosal dissection (ESD) group and the endoscopic mucosal resection with ligation (EMRL) group according to the treatment methods. After comparing the baseline data, propensity score matching was performed to compare the rates of R1 resection and adequacy of vertical margin distance.Results:A total of 186 patients were included in this study, with 139 receiving ESD and 47 receiving EMRL. The R1 resection rates were 12.2% (17/139) and 2.1% (1/47) in the ESD and EMRL group, respectively ( χ2=3.027, P=0.082). A significant difference in vertical margin adequacy was observed between the two groups [69.1% (96/139) VS 85.1% (40/47), χ2=4.598, P=0.032]. After propensity score matching, 46 pairs of cases were included, and there were no significant differences in the R1 resection rate [6.5% (3/46) VS 2.2% (1/46), χ2=0.261, P=0.609] and vertical margin adequacy [78.3% (36/46) VS 84.8% (39/46), χ2=0.649, P=0.420] between the two groups. Univariate and multivariate Logistic regression analyses revealed that operator experience and preoperative biopsy were independent risk factors for inadequate margin. Conclusion:Treatment method may not be the key factor affecting the distance of the vertical margin after endoscopic resection, but preoperative biopsy and operator experience have a significant impact on margins. Biopsy before endoscopic resection should be avoided, and less experienced doctors are recommended to use EMRL method for small NETs due to its ease of execution.
