Rectal tumors, as a common type of gastrointestinal tumor, can be treated through various methods, including endoscopic resection, surgical resection, and radiotherapy. With the in-depth research in the mechanisms of tumors development and the increasing patient demands for quality of life , endoscopic treatment has rapidly advanced due to its advantages of being minimally invasive, promoting faster recovery, and reducing costs. Endoscopic submucosal dissection (ESD), a well-established therapeutic technique, has been widely used for the treatment of precancerous lesions and early-stage tumors in the gastrointestinal tract, as well as for the resection of submucosal tumors such as rectal neuroendocrine tumor. However, ESD faces challenges when dealing with lesions accompanied by severe fibrosis or potential deep submucosal infiltration, leading to difficulties in dissection and the risk of positive vertical margins, which increases the risk of tumor recurrence. The emergence of endoscopic intermuscular dissection (EID) provides a novel approach to address these issues. By dissecting between the inner circular and outer longitudinal muscle layers of the muscularis propria, EID achieves the complete resection of the mucosa, submucosa, and inner circular muscle layer without compromising the integrity of the intestinal wall, thereby resolving the issue of positive vertical margins in histopathological evaluation. The clinical application of EID is still in its early stages. This article reviews the literature to summarize the development and clinical applications of EID technology, providing strategies insights for the minimally invasive endoscopic treatment of rectal tumors.

Rectal tumors, as a common type of gastrointestinal tumor, can be treated through various methods, including endoscopic resection, surgical resection, and radiotherapy. With the in-depth research in the mechanisms of tumors development and the increasing patient demands for quality of life , endoscopic treatment has rapidly advanced due to its advantages of being minimally invasive, promoting faster recovery, and reducing costs. Endoscopic submucosal dissection (ESD), a well-established therapeutic technique, has been widely used for the treatment of precancerous lesions and early-stage tumors in the gastrointestinal tract, as well as for the resection of submucosal tumors such as rectal neuroendocrine tumor. However, ESD faces challenges when dealing with lesions accompanied by severe fibrosis or potential deep submucosal infiltration, leading to difficulties in dissection and the risk of positive vertical margins, which increases the risk of tumor recurrence. The emergence of endoscopic intermuscular dissection (EID) provides a novel approach to address these issues. By dissecting between the inner circular and outer longitudinal muscle layers of the muscularis propria, EID achieves the complete resection of the mucosa, submucosa, and inner circular muscle layer without compromising the integrity of the intestinal wall, thereby resolving the issue of positive vertical margins in histopathological evaluation. The clinical application of EID is still in its early stages. This article reviews the literature to summarize the development and clinical applications of EID technology, providing strategies insights for the minimally invasive endoscopic treatment of rectal tumors.

In order to preliminarily evaluate the efficacy and safety of endoscopic intermuscular dissection (EID) for the treatment of rectal neuroendocrine tumors (R-NETs), a retrospective observational study was conducted on 8 consecutive patients with R-NETs confirmed by postoperative pathology at South China Hospital, Medical School, Shenzhen University from January 2022 to October 2023. The therapeutic efficacy, incidence of complications, and follow-up results were mainly analyzed. The results showed that all 8 cases achieved complete resection after EID, with operation times ranging from 40 to 90 minutes. No bleeding, perforation, fever or electrocoagulation syndrome occurred after operation. The hospital stay was 4 to 6 days. During follow-up of 3 to 24 months, there was no local recurrence or metastasis. Therefore, a preliminary conclusion can be drawn that EID is a safe and feasible treatment for R-NETs.

Objective To study the clinical efficacy and safety of purse-string suture on the treatment of peptic ulcer bleeding. Methods Data of 42 patients with peptic ulcer bleeding treated by purse-string suture with hexiejia combined with endoloop in Dongguan Tung Wah Hospital from January 2016 to January 2017 were retrospectively analyzed. The immediate hemostasis rate, effective hemostasis rate, additional surgery rate, recurrence rate in two weeks and mortality were analyzed. Results Among 20 cases with active bleeding during operation, 19 were immediately arrested, and 1 case of failure was diagnosed as marginal ulcer after gastric resection. The overall effective hemostasis rate was 97. 6%(41/42), additional surgery rate was only 2. 4%( 1/42). The vital signs of 41 patients with successful endoscopic hemostasis were stable after operation, and no fever, hematemesis, black stool or other symptoms occurred. No recurrence of bleeding or death occurred within two weeks. The ulcers were healed well in follow-up of one month. Conclusion Endoscopic purse-string suture is a safe and feasible method for treatment of patients with peptic ulcer bleeding.