Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms

Introduction : A significant rise in incidence of rectal gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has been observed in the last decade. Most detected gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are well differentiated and less than 2 cm in diameter. Endoscopic submucosa...

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Main Authors: Michał Spychalski, Włodzimierz Koptas, Piotr Zelga, Adam Dziki
Format: Article
Language:English
Published: Termedia Publishing House 2016-12-01
Series:Gastroenterology Review
Subjects:
Online Access:https://www.termedia.pl/Role-of-endoscopic-submucosal-dissection-in-treatment-of-rectal-gastroenteropancreatic-neuroendocrine-neoplasms,41,28913,1,1.html
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author Michał Spychalski
Włodzimierz Koptas
Piotr Zelga
Adam Dziki
author_facet Michał Spychalski
Włodzimierz Koptas
Piotr Zelga
Adam Dziki
author_sort Michał Spychalski
collection DOAJ
description Introduction : A significant rise in incidence of rectal gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has been observed in the last decade. Most detected gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are well differentiated and less than 2 cm in diameter. Endoscopic submucosal dissection (ESD) is a new method for endoscopic treatment of such tumors, difficult to resect by conventional endoscopic techniques and thus subject to surgical treatment. Aim: To present the results of the endoscopic treatment of GEP NET tumors in the rectum using ESD in single academic center. Material and methods : From June 2013 to April 2014, 4 cases of GEP-NET in the rectum were treated by ESD in our center. Effectiveness of dissection, complications and tumor recurrence after 3 months of treatment were then retrospectively investigated. Results : The group contained 2 patients with primary rectal GEP-NET (1 male, 1 female; age range: 48–60 years) and 2 with scars after incomplete polypectomy of rectal GEP-NET (1 male, 1 female; 61–65 years). Primary rectal GEP-NET diameters were 0.6 cm and 1.5 cm. Scar resection specimen diameters were 0.7 cm and 1 cm. Mean resection time was 28 min. The en bloc resection rate was 100% (2 of 2) and the histologically complete resection was confirmed in both cases. No foci of neuroendocrine neoplasia were reported in dissected scars. No complications were observed. After 3 months, 3 patients underwent follow-up colonoscopy – no local recurrence was reported. Conclusions : Endoscopic submucosal dissection of rectal GEP-NET should be recommended as a treatment of choice when dealing with lesions over 1 cm in diameter without invasion of the muscle layer. Due to technical difficulties, performing this procedure should be reserved for centers with appropriately trained endoscopic staff.
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spelling doaj-art-7175467be47f414c92bd81624f90b53d2025-01-10T14:06:16ZengTermedia Publishing HouseGastroenterology Review1895-57701897-43172016-12-01121172110.5114/pg.2016.6463528913Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasmsMichał SpychalskiWłodzimierz KoptasPiotr ZelgaAdam DzikiIntroduction : A significant rise in incidence of rectal gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has been observed in the last decade. Most detected gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are well differentiated and less than 2 cm in diameter. Endoscopic submucosal dissection (ESD) is a new method for endoscopic treatment of such tumors, difficult to resect by conventional endoscopic techniques and thus subject to surgical treatment. Aim: To present the results of the endoscopic treatment of GEP NET tumors in the rectum using ESD in single academic center. Material and methods : From June 2013 to April 2014, 4 cases of GEP-NET in the rectum were treated by ESD in our center. Effectiveness of dissection, complications and tumor recurrence after 3 months of treatment were then retrospectively investigated. Results : The group contained 2 patients with primary rectal GEP-NET (1 male, 1 female; age range: 48–60 years) and 2 with scars after incomplete polypectomy of rectal GEP-NET (1 male, 1 female; 61–65 years). Primary rectal GEP-NET diameters were 0.6 cm and 1.5 cm. Scar resection specimen diameters were 0.7 cm and 1 cm. Mean resection time was 28 min. The en bloc resection rate was 100% (2 of 2) and the histologically complete resection was confirmed in both cases. No foci of neuroendocrine neoplasia were reported in dissected scars. No complications were observed. After 3 months, 3 patients underwent follow-up colonoscopy – no local recurrence was reported. Conclusions : Endoscopic submucosal dissection of rectal GEP-NET should be recommended as a treatment of choice when dealing with lesions over 1 cm in diameter without invasion of the muscle layer. Due to technical difficulties, performing this procedure should be reserved for centers with appropriately trained endoscopic staff.https://www.termedia.pl/Role-of-endoscopic-submucosal-dissection-in-treatment-of-rectal-gastroenteropancreatic-neuroendocrine-neoplasms,41,28913,1,1.htmlendoscopic submucosal dissection gastroenteropancreatic neuroendocrine tumors colorectal
spellingShingle Michał Spychalski
Włodzimierz Koptas
Piotr Zelga
Adam Dziki
Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms
Gastroenterology Review
endoscopic submucosal dissection
gastroenteropancreatic neuroendocrine tumors
colorectal
title Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms
title_full Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms
title_fullStr Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms
title_full_unstemmed Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms
title_short Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms
title_sort role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms
topic endoscopic submucosal dissection
gastroenteropancreatic neuroendocrine tumors
colorectal
url https://www.termedia.pl/Role-of-endoscopic-submucosal-dissection-in-treatment-of-rectal-gastroenteropancreatic-neuroendocrine-neoplasms,41,28913,1,1.html
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AT piotrzelga roleofendoscopicsubmucosaldissectionintreatmentofrectalgastroenteropancreaticneuroendocrineneoplasms
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