Related Experiment Video
Updated: May 15, 2026
The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
Comparison between ligation-assisted and precutting endoscopic mucosal resection for small rectal neuroendocrine
Sunghyeok Ryou1, Yunho Jung2, Dae Sung Kim3
1Department of Gastroenterology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
Background/Aims:
Few studies have compared modified endoscopic mucosal resection (EMR) techniques for small rectal neuroendocrine tumors (NETs). This study evaluated the clinical outcomes of ligation-assisted EMR (EMR-L) and precutting EMR (EMR-P) for the treatment of small rectal NETs.
Methods:
We retrospectively reviewed patients who underwent EMR-L or EMR-P for rectal NETs ≤ 10 mm at four university hospitals between January 2018 and December 2022. Primary outcomes were en bloc resection and complete resection rates; secondary outcomes included procedural time and complications.
Results:
Among a total of 195 rectal NETs, 143 were resected using EMR-L and 52 using EMR-P. Although the histopathologically measured lesion size (4.0 ± 1.7 mm vs. 5.2 ± 2.4 mm, p = 0.002) was larger in the EMR-P group, the presence of ulcer or depression and lesion location did not significantly differ between the two groups. The en bloc resection rate (100.0% vs. 96.2%, p = 0.070) and complete resection rate (95.8% vs. 90.4%, p = 0.140) also were not significantly different. However, EMR-L had a significantly shorter procedure time (3.9 ± 2.3 min vs. 9.8 ± 5.6 min, p < 0.001). No significant differences were observed in procedure-related bleeding, perforation, recurrence, or hospital stay between the groups.
Conclusion:
Both EMR-L and EMR-P achieved high en bloc and complete resection rates with favorable safety profiles. However, EMR-L was significantly faster, suggesting that it is a more time-efficient approach for small rectal NET resection.
