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| Therapeutic Effect of ESD in Rectal Neuroendocrine Tumors and Influencing Factors of Incomplete Resection |
| QING Hongyi, WEI Shoujiang, LI Xun |
| Affiliated Hospital of North Sichuan Medical College, Sichuan Nanchong 637000,China |
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Abstract Objective: To investigate the effect of endoscopic submucosal dissection (ESD) on rectal neuroendocrine tumors and to analyze the influencing factors of incomplete resection. Methods: 120 patients with rectal neuroendocrine tumors admitted to our hospital from April 2016 to April 2019 were treated with ESD. The resection and complications of ESD were observed. According to the resection of ESD, the patients were divided into complete resection group and incomplete resection group. In the groups, single factor and multivariate logistic regression were taken to analyze the related factors affecting the incomplete resection of ESD. Results: The patient's ESD operation time was 32~68min, with an average of (45.28±6.93) min. 120 cases of ESD completed complete resection (100%), complete resection of 101 cases (84.17%), and incomplete resection of 19 cases (15.83%).There were no complications such as perforation and hemorrhage during and after operation. The patients were followed up for 6 months to 12 months, with an average of (1.95±0.39) years. There were no lost cases of follow-up and no recurrence or metastasis appeared during the follow-up period. Univariate analysis showed that tumor diameter, depth of invasion, central depression of lesion surface mucosa were associated with incomplete resection of ESD in patients with rectal neuroendocrine tumors (P<0.05), but not with gender, age, chromogranin (CGA), bulging morphology, etc. (P>0.05).Further multivariate logistic regression analysis showed infiltration to the submucosa (OR=7.179, 95% CI=1.206~42.748), tumor diameter>1.5cm (OR=15.709, 95% CI=2.162~114.126), and a central mucosal surface of the lesion with a depression (OR=18.191, 95% CI=4.063~81.456) were risk factors for incomplete resection of ESD in patients with rectal neuroendocrine tumors (P<0.05).Conclusion: ESD is safe and effective in the treatment of rectal neuroendocrine tumors; patients with rectal neuroendocrine tumors infiltrating into the submucosa, tumor diameter >1.5cm, and a central mucosal surface of the lesion with a depression have a high risk of incomplete resection of ESD.
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2020, Vol. 26 
