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Updated: Jan 24, 2026

Establishment and Characterization of Small Bowel Neuroendocrine Tumor Spheroids
09:43

Establishment and Characterization of Small Bowel Neuroendocrine Tumor Spheroids

Published on: October 14, 2019

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EndoVascular Occlusion and Tumor Excision (EVOTE): a Hybrid Approach to Small-Bowel Neuroendocrine Tumors with

Julian K Horwitz1, Michael L Marin1, Richard R P Warner2

  • 1Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|May 16, 2019
PubMed
Abstract

Insights

The EndoVascular Occlusion and Tumor Excision (EVOTE) is a novel hybrid surgical technique for resecting mesenteric metastases from small-bowel neuroendocrine tumors (SBNETs). This approach demonstrates feasibility and safety, enabling complete tumor excision in most patients.

Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Interventional Radiology

Background:

  • Mesenteric metastases from small-bowel neuroendocrine tumors (SBNETs) pose significant surgical challenges due to vascular encasement.
  • Traditional surgical approaches are often limited by the complex anatomy of mesenteric involvement.

Purpose of the Study:

  • To evaluate the feasibility and safety of a new hybrid surgical technique, EndoVascular Occlusion and Tumor Excision (EVOTE), for managing SBNETs with mesenteric metastases.
  • To assess the efficacy of EVOTE in achieving complete tumor resection and its impact on patient outcomes.

Main Methods:

  • The study involved 13 patients with unresectable mesenteric metastases from SBNETs undergoing the EVOTE procedure between 2014 and 2018.
  • EVOTE is a two-stage hybrid approach: Stage 1 involves angiographic evaluation and embolization of encased mesenteric vessels if collateralization is adequate; Stage 2 is the surgical mass excision the following day.

Main Results:

  • Preoperative embolization was successful in 86% of cases, with 2 cases aborted due to pain.
  • Complete surgical excision of the mesenteric mass was achieved in 86% of patients.
  • The 30-day morbidity rate was 29%, with no mortality. One local recurrence was successfully resected with a repeat EVOTE.

Conclusions:

  • The EVOTE technique is a viable and safe hybrid approach for the surgical management of SBNETs with mesenteric metastases.
  • This method facilitates preoperative planning and improves the rate of complete resection for challenging mesenteric masses.
Keywords:
Mesenteric metastasesMetastatic carcinoidSurgical management carcinoidUnresectable carcinoid

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