Endoscopic submucosal dissection for foregut neuroendocrine tumors: an initial study

Area of Science:

• Gastroenterology
• Surgical Oncology
• Endoscopy

Background:

• Foregut neuroendocrine tumors (NETs) require effective and minimally invasive treatment options.
• Accurate histopathological evaluation is crucial for NET management.
• Endoscopic submucosal dissection (ESD) has emerged as a potential therapeutic modality.

Purpose of the Study:

• To assess the feasibility and efficacy of endoscopic submucosal dissection (ESD) for treating foregut neuroendocrine tumors (NETs).
• To evaluate the complete resection rates, complications, and long-term outcomes of ESD in this patient cohort.

Main Methods:

• A retrospective study included 24 patients with 29 foregut NETs diagnosed between April 2008 and December 2010.
• Patients had no evidence of lymph node or distant metastases on preoperative imaging.
• ESD was performed under general anesthesia, focusing on en bloc resection of submucosal tumors.

Main Results:

• ESD successfully resected 28 of 29 (96.6%) foregut NETs in an en bloc fashion.
• The average procedure time was 20.3 minutes for lesions with an average diameter of 9.4 mm.
• One case of delayed bleeding and one case of incomplete resection (requiring surgery) were reported; no perforations occurred. Local recurrence was observed in one patient, successfully treated with repeat ESD. No metastasis or deaths were recorded during follow-up.

Conclusions:

• Endoscopic submucosal dissection (ESD) is a safe, feasible, and effective endoscopic treatment for selected foregut NETs.
• ESD facilitates accurate histopathological assessment and provides curative treatment options.
• The procedure demonstrates a high success rate with minimal complications and favorable long-term outcomes.