关键词: 神经分泌肿瘤, 直肠, 超声内镜, 内镜下黏膜剥离术, 内镜下黏膜挖除术

Abstract:

Objective Exploring the comparison of the effi cacy and recurrence rate of endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), and endoscopic submucosal resection (ESE) in the treatment of rectal neuroendocrine tumors under the precise localization of tumor volume and level using endoscopic ultrasound. Method Retrospective analysis of clinical data of patients who received endoscopic minimally invasive treatment at Qingdao Municipal Hospital from October 2018 to July 2022 and were pathologically diagnosed with rectal neuroendocrine tumors. Analysis of preoperative imaging features, endoscopic ultrasound diagnosis, surgical data, pathological data, and postoperative follow-up of EMR, ESD, and ESE surgical methods for rectal neuroendocrine tumors. Result A total of 95 patients were included in the clinical data, including 52 who underwent ESD surgery, 30 who underwent EMR surgery, and 13 who underwent ESE surgery. The average maximum diameter of lesions removed in the ESD group was signifi cantly larger than that in the EMR group, and the ESD group had a larger tumor resection area compared to the EMR group, with signifi cant diff erences (P＜0.05). The surgical time of ESD group and ESE group was signifi cantly longer than that of EMR group, and the diff erence was signifi cant (P ＜ 0.05). There was no signifi cant diff erence among the three methods in terms of intraoperative surgical rescue, postoperative margin involvement rate, occurrence of postoperative complications, postoperative discharge time, and postoperative recurrence rate(P ＞ 0.05). Endoscopic ultrasound examination shows that most of the lesions are hypoechoic, with clear boundaries and intact tube walls. The lesions mainly originate from the submucosal layer and mucosal muscle layer. Conclusion Before surgery, the most suitable endoscopic minimally invasive surgery method is selected based on the localization of tumor volume and level by endoscopic ultrasound. By utilizing the advantages of EMR, ESD, and ESE, the surgical safety can be improved.

Key words: Neuroendocrine neoplasm, Rectal, Endoscopic ultrasound, Endoscopic mucosal dissection, Endoscopic submucosal excavation