scholarly journals Ligation-assisted endoscopic mucosal resection has high complete resection rate in rectal carcinoid tumor

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ming-Yao Su ◽  
Cheng-Tang Chiu
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Surgical Resection ◽  
Complete Resection ◽  
Carcinoid Tumors ◽  
Rectal Carcinoid ◽  
Resection Rate ◽  
Therapeutic Modalities ◽  
Mucosal Resection ◽  
Complete Resection Rate ◽  
The Mean

Abstract Aim We aimed to compare the outcomes of different therapeutic modalities in rectal carcinoid tumors. Method We retrospectively collected 145 patients with rectal carcinoid tumors which were pathologically diagnosed from 2005/01/01 to 2016/12/31. We compared tumor size, complete resection rate and recurrent rate between different therapeutic modalities. Then, prospectively compared the treatment outcomes of 28 patients treated with ligation assisted endoscopic mucosal resection (LEMR) and 25 patients treated with endoscopic mucosal resection with cap (EMRC). Result The mean size of tumors was 6.5 mm (1–25 mm), and the mean follow-up duration was 26 months (6–118 months). The therapeutic modalities included ligation-assisted endoscopic mucosal resection (LEMR) (25 tumors, 17%), endoscopic mucosal resection (EMR) (31 tumors, 21%), snare polypectomy (30 tumors, 21%), biopsy forceps removal (46 tumors, 32%) and surgical resection (13 tumors, 11%), including 6 tumors treated with transanal endoscopic microsurgery (TEM) method. In view of pathologically complete resection rate, LEMR was highest (100%), followed by surgical resection (85%). However, EMR only had 42% pathologically complete resection rate. Besides, LEMR and surgical resection had no local recurrence and significantly higher clinically complete resection rate, compared to other treatments. For the further prospective study, complete resection was noted in 28 (100%) patients in LEMR group and 13 (52%) patients in EMRC group. Conclusion In the treatment of rectal carcinoid tumors, LEMR is safe and effective compared with traditional endoscopic treatments.

scholarly journals Ligation-Assisted Endoscopic Mucosal Resection Has High Complete Resection Rate in Rectal Carcinoid Tumor

2021 ◽  
Author(s):  
Ming-Yao Su ◽  
Cheng-Tang Chiu
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Surgical Resection ◽  
Complete Resection ◽  
Carcinoid Tumors ◽  
Rectal Carcinoid ◽  
Resection Rate ◽  
Therapeutic Modalities ◽  
Mucosal Resection ◽  
Complete Resection Rate ◽  
The Mean

Abstract Aim: We aimed to compare the outcomes of different therapeutic modalities in rectal carcinoid tumors. Method: We retrospectively collected 145 patients with rectal carcinoid tumors which were pathologically diagnosed from 2005/01/01 to 2016/12/31. We compared tumor size, complete resection rate and recurrent rate between different therapeutic modalities. Then, prospectively compared the treatment outcmes of 28 patients treated with ligation assisted endoscopic mucosal resection (LEMR) and 25 patients treated with endoscopic mucosal resection with cap (EMRC). Result: The mean size of tumors was 6.5mm (1-25mm), and the mean follow-up duration was 26 months (6-118 months). The therapeutic modalities included ligation-assisted endoscopic mucosal resection (LEMR) (25 tumors, 17%), endoscopic mucosal resection (EMR) (31 tumors, 21%), snare polypectomy (30 tumors, 21%), biopsy forceps removal (46 tumors, 32%) and surgical resection (13 tumors, 11%), including 6 tumors treated with transanal endoscopic microsurgery (TEM) method. In view of pathologically complete resection rate, LEMR was highest (100%), followed by surgical resection (85%). However, EMR only had 42% pathologically complete resection rate. Besides, LEMR and surgical resection had no local recurrence and significantly higher clinically complete resection rate, compared to other treatments. For the further prospective study, complete resection were noted in 28 (100%) patients in LEMR group and 13 (52%) patients in EMRC group. Conclusion: In the treatment of rectal carcinoid tumors, LEMR is safe and effective compared with traditional endoscopic treatments.

Underwater endoscopic mucosal resection for superficial nonampullary duodenal adenomas

Endoscopy ◽  
2017 ◽  
Author(s):  
Yasushi Yamasaki ◽  
Noriya Uedo ◽  
Yoji Takeuchi ◽  
Koji Higashino ◽  
Noboru Hanaoka ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Large Scale ◽  
Complete Resection ◽  
University Hospital ◽  
Resection Rate ◽  
Mucosal Resection ◽  
Duodenal Adenomas ◽  
Complete Resection Rate ◽  
Medical Network

Abstract Background and study aim Underwater endoscopic mucosal resection (UEMR) was recently developed in a Western country. A prospective cohort study to investigate the effectiveness of UEMR was conducted in patients with small superficial nonampullary duodenal adenomas. Patients and methods Patients with duodenal adenomas ≤ 20 mm were enrolled. After the duodenal lumen had been filled with physiological saline, UEMR was performed without submucosal injection. Endoclip closure was attempted for all mucosal defects after UEMR. Follow-up endoscopy with biopsy was performed 3 months later. The primary end point was the complete resection rate, defined as neither endoscopic nor histological residue of adenoma at the follow-up endoscopy. Results 30 patients with 31 lesions were enrolled. The mean (SD) tumor size was 12.0 mm (7.3). The complete resection rate was 97 % (90 % confidence interval, 87 % – 99 %). The en bloc resection rate was 87 %. All mucosal defects were successfully closed by endoclips. No adverse events occurred except for one case of mild aspiration pneumonia. Conclusions UEMR is efficacious for the treatment of small duodenal adenomas, but further large-scale trials are warranted to confirm these results. Trial registered at University Hospital Medical Network Clinical Trials Registry (UMIN 000018710).

Efficacy of precutting endoscopic mucosal resection with full or partial circumferential incision using a snare tip for difficult colorectal lesions

Endoscopy ◽  
2019 ◽  
Vol 51 (09) ◽  
pp. 871-876 ◽  
Author(s):  
Naohisa Yoshida ◽  
Ken Inoue ◽  
Osamu Dohi ◽  
Ritsu Yasuda ◽  
Ryohei Hirose ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Complete Resection ◽  
Benign Lesions ◽  
Resection Rate ◽  
En Bloc ◽  
Mucosal Resection ◽  
Therapeutic Outcomes ◽  
Mucosal Incision

Abstract Background We analyzed the efficacy of precutting endoscopic mucosal resection (EMR), which is a method of making a full or partial circumferential mucosal incision around a tumor with a snare tip for en bloc resection. Methods We reviewed cases from 2011 to 2018 in which precutting EMR (n = 167) and standard EMR (n = 557) were performed for lesions of 10 – 30 mm. Precutting EMR was indicated for benign lesions of 20 – 30 mm or lesions of < 20 mm for which standard EMR was difficult. Through propensity score matching of the two groups, the therapeutic outcomes for 35 lesions of ≥ 20 mm and 98 lesions of < 20 mm in each group were analyzed. Results In the two sizes of lesion, there were significant differences between the precutting and standard groups in the en bloc resection rate (≥ 20 mm 88.6 % vs. 48.5 %, P < 0.001; < 20 mm 98.0 % vs. 85.7 %, P = 0.004) and the histological complete resection rate (≥ 20 mm 71.4 % vs. 42.9 %, P = 0.02; < 20 mm 87.8 % vs. 67.3 %, P < 0.001). Conclusion Precutting EMR enabled high en bloc resection rates in cases involving difficult lesions.

The efficacy and safety of underwater endoscopic mucosal resection for ≥10-mm colorectal polyps: systematic review and meta-analysis

Endoscopy ◽  
2020 ◽  
Author(s):  
De-feng Li ◽  
Ming-Guang Lai ◽  
Mei-feng Yang ◽  
Zhi-yuan Zou ◽  
Jing Xu ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Colorectal Polyps ◽  
Complete Resection ◽  
R0 Resection ◽  
Efficacy And Safety ◽  
Resection Rate ◽  
En Bloc ◽  
Mucosal Resection

Abstract Background Underwater endoscopic mucosal resection (UEMR) is a promising strategy for nonpedunculated colorectal polyp removal. However, the efficacy and safety of the technique for the treatment of ≥ 10-mm colorectal polyps remain unclear. We aimed to comprehensively assess the efficacy and safety of UEMR for polyps sized 10–19 mm and ≥ 20 mm. Methods PubMed, EMBASE, and the Cochrane Library databases were searched for relevant articles from January 2012 to November 2019. Primary outcomes were the rates of adverse events and residual polyps. Secondary outcomes were the complete resection, en bloc resection, and R0 resection rates. Results 18 articles including 1142 polyps from 1093 patients met our inclusion criteria. The overall adverse event and residual polyp rates were slightly lower for UEMR when removing colorectal polyps of 10–19 mm vs. ≥ 20 mm (3.5 % vs. 4.3 % and 1.2 % vs. 2.6 %, respectively). The UEMR-related complete resection rate was slightly higher for colorectal polyps of 10–19 mm vs. ≥ 20 mm (97.9 % vs. 92.0 %). However, the en bloc and R0 resection rates were dramatically higher for UEMR removal of polyps of 10–19 mm vs. ≥ 20 mm (83.4 % vs. 36.1 % and 73.0 % vs. 40.0 %, respectively). In addition, univariate meta-regression revealed that polyp size was an independent predictor for complete resection rate (P = 0.03) and en bloc resection (P = 0.01). Conclusions UEMR was an effective and safe technique for the removal of ≥ 10-mm nonpedunculated colorectal polyps. However, UEMR exhibited low en bloc and R0 resection rates for the treatment of ≥ 20-mm polyps.

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