Double Band Ligation-Assisted Endoscopic Submucosal Resection for Rectal Neuroendocrine Tumors: Comparison With...

Area of Science:

• Gastroenterology
• Surgical Oncology
• Endoscopic Procedures

Background:

• Small submucosal rectal neuroendocrine tumors (NETs) require effective resection techniques.
• Endoscopic mucosal resection with ligation (EMR-L) is a standard approach.
• A novel technique, double band ligation-assisted endoscopic submucosal resection (ESR), was developed to improve resection margins.

Purpose of the Study:

• To compare the feasibility, safety, and effectiveness of ESR versus EMR-L for small rectal NETs.
• To evaluate key outcomes including resection rates, margin distances, and adverse events.

Main Methods:

• A retrospective study comparing ESR (n=45) and EMR-L (n=26) for rectal NETs ≤10 mm.
• Data collected included en bloc resection rate, complete resection rate, procedure time, margin distance, and adverse events.

Main Results:

• All patients achieved en bloc resections.
• ESR demonstrated a significantly higher complete resection rate (100%) compared to EMR-L (88.5%, P=0.045).
• ESR achieved significantly greater vertical and lateral margin distances (P<0.001 and P=0.008, respectively) with no increase in procedure time, adverse events, or costs.

Conclusions:

• Double band ligation-assisted endoscopic submucosal resection (ESR) is a safe and effective technique for complete resection of small submucosal rectal neuroendocrine tumors.
• Further validation through larger, prospective, multicenter studies is warranted.